Provider Demographics
NPI:1811189392
Name:PREMIER HOME HEALTCARE, INC.
Entity Type:Organization
Organization Name:PREMIER HOME HEALTCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:B
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-536-9902
Mailing Address - Street 1:2105 HARTWOOD MARSH RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-5389
Mailing Address - Country:US
Mailing Address - Phone:352-536-9902
Mailing Address - Fax:352-243-4957
Practice Address - Street 1:2105 HARTWOOD MARSH RD
Practice Address - Street 2:SUITE 5
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-5389
Practice Address - Country:US
Practice Address - Phone:352-536-9902
Practice Address - Fax:352-243-4957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1221280002Medicare NSC