Premium Choice Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

698669300020 Issued in MN

Legal business name

PREMIUM CHOICE CARE LLC

Practice address

1983 Geneva Ave N Ste 1983
Oakdale, MN 55128-4108

Phone

(651) 239-6149

Fax

(651) 772-3357

NPI assigned

Sep 13, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Ferdinand Mbaanik Fondo

Title

Manager

Phone

(651) 239-6149

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573516800000",
    "number": "1609201235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1949 GENEVA AVE N STE 1983",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551284108",
            "telephone_number": "651-239-6149",
            "fax_number": "651-772-3357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1983 GENEVA AVE N STE 1983",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551284108",
            "telephone_number": "651-239-6149",
            "fax_number": "651-772-3357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM CHOICE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-13",
        "last_updated": "2019-11-12",
        "status": "A",
        "authorized_official_last_name": "FONDO",
        "authorized_official_first_name": "FERDINAND",
        "authorized_official_middle_name": "MBAANIK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "651-239-6149",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "698669300020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Selena Pineda-Martinez
• Kathleen Piontek
• Allison Pokrandt, BA, LGSW
• Tenzin Choedon Pontsang
• Amanda Lee Pothen, COTA
• Amber Priestley, LMFT
• Prime Choice Home Care Solutions LLC
• Primer Supportive Network LLC
• Priority Health Home Care Inc
• Marlan Proctor, BA

• Home Health Agency in Oakdale, MN
• Providers in Oakdale, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; 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.