Provider Demographics
NPI:1710036157
Name:PREMIER CARE PROVIDERS CORPORATION
Entity Type:Organization
Organization Name:PREMIER CARE PROVIDERS CORPORATION
Other - Org Name:PREMIER CARE PROVIDERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TEODORICO
Authorized Official - Middle Name:J
Authorized Official - Last Name:MENDOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-985-9012
Mailing Address - Street 1:229 BEVERLEY CT
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-2872
Mailing Address - Country:US
Mailing Address - Phone:847-985-9012
Mailing Address - Fax:847-524-1867
Practice Address - Street 1:229 BEVERLEY CT
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-2872
Practice Address - Country:US
Practice Address - Phone:847-985-9012
Practice Address - Fax:847-524-1867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered251F00000XAgenciesHome Infusion
Not Answered251X00000XAgenciesSupports Brokerage
Not Answered343800000XTransportation ServicesSecured Medical Transport (VAN)
Not Answered343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Not Answered344600000XTransportation ServicesTaxi
Not Answered347C00000XTransportation ServicesPrivate Vehicle
Not Answered347E00000XTransportation ServicesTransportation Broker