Premier Hospice, LLC
Organization Active NPI Community Based Hospice Care Agency · Troy, MI
NPI 1003060310 · NPPES record last updated Apr 14, 2010
Key facts
- NPI
- 1003060310
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- PREMIER HOSPICE, LLC
- Practice address
- 33333 Dequindre Rd
Suite D
Troy, MI 48083-4624 - Phone
- (877) 580-1885
- Fax
- (248) 597-9015
- NPI assigned
- Nov 13, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. Mohammad Qazi, P.T.
- Title
- President
- Phone
- (877) 580-1885
Owners & managing parties with NPI records 2
-
Samuel E Ross, M.D.
Other NPIs with the same Medicare PAC ID 1
Practitioners 1
Affiliated clinicians 8
-
Malaz Alatassi, M.D.
-
Mirza A.H. Beg, M.D.
-
Raafat Issa, M.D
-
Drew Joseph Packey, D.O.
-
Amir Sankari, M.D.
-
Samuel E Ross, M.D.
Medicare Care Compare: Hospice
- Listed as
- Premier Hospice
- Ownership
- Other
- Certified
- Jun 15, 2011
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D2011288 | Premier Hospice | Certificate of waiver | Aug 12, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Hospice certification: CCN 231623
- Legal name
- PREMIER HOSPICE, LLC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Jun 15, 2011
- Last certification
- Jun 15, 2011
- Ownership / control type
- Other
- Organization structure
- LLC · Proprietary
- Incorporated
- Aug 21, 2008 in MI
- Enrollment address
- 33259 Dequindre Rd
Ste C
Troy, MI 48083-4628
All disclosed owners & managing parties 5
| Name | Role | Since | Share |
|---|---|---|---|
| Mohammad a. Qazi |
5% Or Greater Direct Ownership Interest | Jan 1, 2021 | 100% |
| Corporate Officer |
Aug 21, 2008 | ||
| Corporate Director |
Aug 21, 2008 | ||
| W-2 Managing Employee |
Aug 21, 2008 | ||
| Suzan K Brown |
W-2 Managing Employee |
Jan 24, 2025 | |
| Azeem Qazi |
Corporate Officer |
Jun 1, 2023 | |
| Talha Mirza |
Contracted Managing Employee |
Jan 24, 2025 | |
| Eli Ross |
Contracted Managing Employee |
Nov 10, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081124000576 | MI | Part a Provider - Hospice | 4587724364 | Practice locations: Troy, MI |
National Provider Directory
Locations
33259 Dequindre Rd
Ste C
Troy, MI 48083
Phone (248) 588-1885
33333 Dequindre Rd
Ste D
Troy, MI 48083
Phone (877) 580-1885
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
33333 Dequindre Rd
Suite D
Troy, MI 48083-4624
Mailing address
33333 Dequindre Rd
Suite D
Troy, MI 48083-4624
Phone (877) 580-1885
Other providers in Troy, MI
- Precision Home Care
- Prem Khilanani MD PC
- Premier Cardiovascular Consultants PC
- Premier Home Care Solution Co
- Premier Home Health Solutions Inc
- Premier Hospice, LLC
- Premier Private Physicians, PLC
- Premise Health of Michigan Medical PC
- Margarita G Presas
- Prescribed Therapy LLC
All providers in Troy, MI · Community Based Hospice Care Agency in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.