Provider Demographics
NPI:1598840795
Name:PREMIUM HOME HEALTH SERVICE INC
Entity Type:Organization
Organization Name:PREMIUM HOME HEALTH SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:DAGHER
Authorized Official - Suffix:IX
Authorized Official - Credentials:
Authorized Official - Phone:313-213-4460
Mailing Address - Street 1:20504 WILLIAMSBURG RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2714
Mailing Address - Country:US
Mailing Address - Phone:313-213-4460
Mailing Address - Fax:313-724-9803
Practice Address - Street 1:20504 WILLIAMSBURG RD
Practice Address - Street 2:
Practice Address - City:DEARBORN HTS
Practice Address - State:MI
Practice Address - Zip Code:48127-2714
Practice Address - Country:US
Practice Address - Phone:313-213-4460
Practice Address - Fax:313-724-9803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health