Provider Demographics
NPI:1497299937
Name:PREMIUM HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:PREMIUM HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLLORINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-466-6870
Mailing Address - Street 1:601 E 18TH ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07501-1696
Mailing Address - Country:US
Mailing Address - Phone:973-653-3011
Mailing Address - Fax:
Practice Address - Street 1:601 E 18TH ST
Practice Address - Street 2:SUITE 3
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07501-1696
Practice Address - Country:US
Practice Address - Phone:973-653-3011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-16
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health