MEDICARE: MICHIGAN PREMIER HOME HEALTH CARE 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

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	:	1821327834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHIGAN PREMIER HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	312 E HOUGHTON AVE
Second Line	:	SUITE A
City	:	WEST BRANCH
State	:	MI
Zip	:	48661-1187
Country	:	US
Telephone Number	:	989-345-0021
Fax Number	:	989-345-0022

Provider Business Practice Location Address
First Line	:	312 E HOUGHTON AVE
Second Line	:	SUITE A
City	:	WEST BRANCH
State	:	MI
Zip	:	48661-1187
Country	:	US
Telephone Number	:	989-345-0021
Fax Number	:	989-345-0022

Authorized Official
Title or Position	:	ADMINSTRATOR
Name	:	MRS. JABEEN BUKHARI
Credential	:
Telephone Number	:	989-345-0021

Provider Enumeration Date	:	12/22/2009
Last Update Date	:	10/16/2013

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