Premiercare @Home LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

159-R-1694 Issued in GA

Legal business name

PREMIERCARE @HOME LLC

Practice address

302 N Westberry St
Sylvester, GA 31791-2125

Phone

(229) 288-2638

NPI assigned

Dec 2, 2016

Last updated

Dec 2, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Gwendolyn McDaniel

Title

Ownerd

Phone

(229) 288-2638

Specialties & licenses 1

Addresses

Other names 1

• PremierCare atHome LLC Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1480636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480636800000",
    "number": "1083157440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 N WESTBERRY ST",
            "city": "SYLVESTER",
            "state": "GA",
            "postal_code": "317912125",
            "telephone_number": "229-288-2638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 N WESTBERRY ST",
            "city": "SYLVESTER",
            "state": "GA",
            "postal_code": "317912125",
            "telephone_number": "229-288-2638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERCARE @HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-02",
        "last_updated": "2016-12-02",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_title_or_position": "OWNERD",
        "authorized_official_telephone_number": "229-288-2638",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "159-R-1694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PremierCare atHome LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Home Health Agency in Sylvester, GA
• Providers in Sylvester, GA by specialty
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.