Provider Demographics
NPI:1568027712
Name:PRIORITY HOME HEALTH LLC
Entity Type:Organization
Organization Name:PRIORITY HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLASMATUS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:509-942-8341
Mailing Address - Street 1:98216 E SIDIBE PR SE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-0009
Mailing Address - Country:US
Mailing Address - Phone:509-588-7017
Mailing Address - Fax:509-588-7017
Practice Address - Street 1:98216 E SIDIBE PR SE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338-0009
Practice Address - Country:US
Practice Address - Phone:509-588-7017
Practice Address - Fax:509-588-7017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-03
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAIHS.FS.60917192Medicaid