Provider Demographics
NPI:1891812558
Name:PREMIER HOME HEALTH CARE SERVICES, INC
Entity type:Organization
Organization Name:PREMIER HOME HEALTH CARE SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIANDURCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-428-7722
Mailing Address - Street 1:445 HAMILTON AVE
Mailing Address - Street 2:10TH FLOOR
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-1807
Mailing Address - Country:US
Mailing Address - Phone:914-428-7722
Mailing Address - Fax:914-428-2404
Practice Address - Street 1:71 BRADLEY RD
Practice Address - Street 2:SUITE 7B
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-2662
Practice Address - Country:US
Practice Address - Phone:203-245-4153
Practice Address - Fax:203-245-4673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0005251J00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0005OtherSTATE LICENSE