Provider Demographics
NPI:1669518056
Name:PREMIER HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:PREMIER HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:N
Authorized Official - Last Name:ANEMELU
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:973-674-0299
Mailing Address - Street 1:192 CENTRAL AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-3323
Mailing Address - Country:US
Mailing Address - Phone:973-674-0299
Mailing Address - Fax:973-674-0677
Practice Address - Street 1:192 CENTRAL AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-3323
Practice Address - Country:US
Practice Address - Phone:973-674-0299
Practice Address - Fax:973-674-0677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0091600251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJHP0091600OtherSTATE LICENSE NUMBER