Provider Demographics
NPI:1568580918
Name:PREMIER HOME CARE, CORP.
Entity Type:Organization
Organization Name:PREMIER HOME CARE, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VILAYPHONE
Authorized Official - Middle Name:
Authorized Official - Last Name:THAWNGHMUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-322-2242
Mailing Address - Street 1:8444 WHISPER TRCE
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-7118
Mailing Address - Country:US
Mailing Address - Phone:614-327-7630
Mailing Address - Fax:
Practice Address - Street 1:610 TAYLOR STATION RD STE A
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-3587
Practice Address - Country:US
Practice Address - Phone:614-863-8950
Practice Address - Fax:614-863-8980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2827892Medicaid
368215Medicare Oscar/Certification