Provider Demographics
NPI:1104612167
Name:PREMIUM HOME HEALTH CARE
Entity type:Organization
Organization Name:PREMIUM HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:POLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-486-6390
Mailing Address - Street 1:2260 S VAUGHN WAY APT 204
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1366
Mailing Address - Country:US
Mailing Address - Phone:720-486-6390
Mailing Address - Fax:
Practice Address - Street 1:14001 E ILIFF AVE STE 400
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1427
Practice Address - Country:US
Practice Address - Phone:720-486-6390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health