Provider Demographics
NPI:1356037634
Name:PREMIUM CARE SERVIES INC.
Entity type:Organization
Organization Name:PREMIUM CARE SERVIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALDRIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JONKAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-348-8071
Mailing Address - Street 1:7596 HOLLY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-8713
Mailing Address - Country:US
Mailing Address - Phone:301-281-3831
Mailing Address - Fax:
Practice Address - Street 1:7596 HOLLY RIDGE DR
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060-8713
Practice Address - Country:US
Practice Address - Phone:301-281-3831
Practice Address - Fax:410-431-3079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health