Provider Demographics
NPI:1275739047
Name:PREMIER NURSING, INC.
Entity Type:Organization
Organization Name:PREMIER NURSING, INC.
Other - Org Name:BONUM HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADIMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-556-3711
Mailing Address - Street 1:2000 W MAGNOLIA BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-1751
Mailing Address - Country:US
Mailing Address - Phone:818-556-3711
Mailing Address - Fax:818-556-3811
Practice Address - Street 1:2000 W MAGNOLIA BLVD STE 206
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-1751
Practice Address - Country:US
Practice Address - Phone:818-556-3711
Practice Address - Fax:818-556-3811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000914251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059076Medicare Oscar/Certification