Provider Demographics
NPI:1619643350
Name:KING PREMIER CARE SERVICE, LLC
Entity Type:Organization
Organization Name:KING PREMIER CARE SERVICE, LLC
Other - Org Name:KING PREMIER CARE SERVICE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-592-0630
Mailing Address - Street 1:2169 WINTERMERE POINTE DR
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-5439
Mailing Address - Country:US
Mailing Address - Phone:407-592-0630
Mailing Address - Fax:
Practice Address - Street 1:2169 WINTERMERE POINTE DR
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-5439
Practice Address - Country:US
Practice Address - Phone:407-592-0630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-23
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care