Provider Demographics
NPI:1649412503
Name:PLATINUM HOME HEALTHCARE, LLC
Entity Type:Organization
Organization Name:PLATINUM HOME HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DESIGNATED MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AKILAH
Authorized Official - Middle Name:D
Authorized Official - Last Name:PENNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-497-6448
Mailing Address - Street 1:11875 NERO DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-6913
Mailing Address - Country:US
Mailing Address - Phone:314-497-6448
Mailing Address - Fax:314-921-5044
Practice Address - Street 1:11875 NERO DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-6913
Practice Address - Country:US
Practice Address - Phone:314-497-6448
Practice Address - Fax:314-921-5044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-24
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care