Provider Demographics
NPI:1821327834
Name:MICHIGAN PREMIER HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:MICHIGAN PREMIER HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JABEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUKHARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-345-0021
Mailing Address - Street 1:312 E HOUGHTON AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-1187
Mailing Address - Country:US
Mailing Address - Phone:989-345-0021
Mailing Address - Fax:989-345-0022
Practice Address - Street 1:312 E HOUGHTON AVE
Practice Address - Street 2:SUITE A
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-1187
Practice Address - Country:US
Practice Address - Phone:989-345-0021
Practice Address - Fax:989-345-0022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-22
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI182327834Medicaid
MI182327834Medicaid