Provider Demographics
NPI:1508420662
Name:PREMIER HOME CARE, LLC.
Entity Type:Organization
Organization Name:PREMIER HOME CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ENDICOTT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:870-897-7901
Mailing Address - Street 1:807 MILL RD
Mailing Address - Street 2:
Mailing Address - City:POCAHONTAS
Mailing Address - State:AR
Mailing Address - Zip Code:72455-4959
Mailing Address - Country:US
Mailing Address - Phone:870-897-7901
Mailing Address - Fax:833-872-6565
Practice Address - Street 1:807 MILL RD
Practice Address - Street 2:
Practice Address - City:POCAHONTAS
Practice Address - State:AR
Practice Address - Zip Code:72455-4959
Practice Address - Country:US
Practice Address - Phone:870-897-7901
Practice Address - Fax:833-872-6565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care