Provider Demographics
NPI:1518140615
Name:PREMIER HHC LLC
Entity Type:Organization
Organization Name:PREMIER HHC LLC
Other - Org Name:AUTUMN HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.O.O./ALTERNATE ADMIN
Authorized Official - Prefix:MR
Authorized Official - First Name:BETSON
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:ZACHARIAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-890-4743
Mailing Address - Street 1:1600 PIEDMONT PL
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-5041
Mailing Address - Country:US
Mailing Address - Phone:214-483-6800
Mailing Address - Fax:214-483-6802
Practice Address - Street 1:1600 PIEDMONT PL
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-5041
Practice Address - Country:US
Practice Address - Phone:214-483-6800
Practice Address - Fax:214-483-6802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747143OtherMEDICARE PTAN