Provider Demographics
NPI:1417906264
Name:PREMIER HOME CARE, INC.
Entity Type:Organization
Organization Name:PREMIER HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:BROTSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-969-2225
Mailing Address - Street 1:1800 BYBERRY RD STE 1201
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-3524
Mailing Address - Country:US
Mailing Address - Phone:215-969-2225
Mailing Address - Fax:215-969-2276
Practice Address - Street 1:1800 BYBERRY RD STE 1201
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-3524
Practice Address - Country:US
Practice Address - Phone:215-969-2225
Practice Address - Fax:215-969-2276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA02620501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015021530001Medicaid
PA1015021530001Medicaid