Provider Demographics
NPI:1760997555
Name:PREMIER HOME CARE
Entity Type:Organization
Organization Name:PREMIER HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUIS'JEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-708-2405
Mailing Address - Street 1:8311 TWO NOTCH RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-6303
Mailing Address - Country:US
Mailing Address - Phone:803-696-4993
Mailing Address - Fax:
Practice Address - Street 1:8311 TWO NOTCH RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-6303
Practice Address - Country:US
Practice Address - Phone:803-696-4993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-03
Last Update Date:2017-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCIHCP-0788251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health