Provider Demographics
NPI:1285398040
Name:PREMIER CHOICE HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:PREMIER CHOICE HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:B
Authorized Official - Last Name:NCHAKO NGAKWI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-370-3501
Mailing Address - Street 1:4355 N GARLAND AVE APT 3220
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-8527
Mailing Address - Country:US
Mailing Address - Phone:405-370-3501
Mailing Address - Fax:
Practice Address - Street 1:4355 N GARLAND AVE APT 3220
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-8527
Practice Address - Country:US
Practice Address - Phone:405-370-3501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty