MEDICARE: PREMIER HOMECARE. 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	251J00000X	Nursing Care Agency	HC3386	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730212499
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER HOMECARE. LLC

Provider Business Mailing Address
First Line	:	4096 HICKORY BLVD
Second Line	:
City	:	GRANITE FALLS
State	:	NC
Zip	:	28630-8372
Country	:	US
Telephone Number	:	828-396-9111
Fax Number	:	828-396-9112

Provider Business Practice Location Address
First Line	:	4096 HICKORY BLVD
Second Line	:
City	:	GRANITE FALLS
State	:	NC
Zip	:	28630-8372
Country	:	US
Telephone Number	:	828-396-9111
Fax Number	:	828-396-9112

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. BETH HATTON JARDON
Credential	:	R.N.
Telephone Number	:	828-396-9111

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	08/22/2020

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