Provider Demographics
NPI:1568684892
Name:PREMCO, INC.
Entity Type:Organization
Organization Name:PREMCO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:HACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-636-7095
Mailing Address - Street 1:PO BOX 266
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10802-0266
Mailing Address - Country:US
Mailing Address - Phone:914-636-7095
Mailing Address - Fax:
Practice Address - Street 1:11 BEECHWOOD AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-6818
Practice Address - Country:US
Practice Address - Phone:914-636-7095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies