MEDICARE: PREMIER HOME HEALTHCARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1720702251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER HOME HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	6160 SUMMIT DR N STE 208
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55430-2181
Country	:	US
Telephone Number	:	612-208-1839
Fax Number	:	612-208-1834

Provider Business Practice Location Address
First Line	:	6160 SUMMIT DR N STE 208
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55430-2181
Country	:	US
Telephone Number	:	612-208-1839
Fax Number	:	612-208-1834

Authorized Official
Title or Position	:	DIRECTOR
Name	:	YONIS AHMED
Credential	:
Telephone Number	:	612-208-1839

Provider Enumeration Date	:	09/28/2022
Last Update Date	:	05/07/2026

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