Provider Demographics
NPI:1205040417
Name:PREMIER HOME HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:PREMIER HOME HEALTH CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIANDURCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-428-7722
Mailing Address - Street 1:1 N LEXINGTON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-1712
Mailing Address - Country:US
Mailing Address - Phone:914-428-7722
Mailing Address - Fax:914-428-2404
Practice Address - Street 1:2125 CENTER AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-5859
Practice Address - Country:US
Practice Address - Phone:201-461-9595
Practice Address - Fax:201-461-9830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0231601251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJHP0231601OtherBRANCH STATE C.A. LIC #