Provider Demographics
NPI:1003149386
Name:PREMIERE HOME HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:PREMIERE HOME HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:O'SHIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-831-0852
Mailing Address - Street 1:170 PASTURE CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-9494
Mailing Address - Country:US
Mailing Address - Phone:937-831-0852
Mailing Address - Fax:
Practice Address - Street 1:170 PASTURE CT
Practice Address - Street 2:
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-9494
Practice Address - Country:US
Practice Address - Phone:937-831-0852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care