Provider Demographics
NPI:1578743787
Name:PREMIUM HOME HEALTH CARE
Entity Type:Organization
Organization Name:PREMIUM HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAPHNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-208-8062
Mailing Address - Street 1:3195 CALDER ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1410
Mailing Address - Country:US
Mailing Address - Phone:281-208-8062
Mailing Address - Fax:
Practice Address - Street 1:3195 CALDER ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1410
Practice Address - Country:US
Practice Address - Phone:281-208-8062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health