Premium Care Group

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HPO248300 Issued in NJ

Legal business name

PREMIUM CARE GROUP

Practice address

301 Commerce Dr
Moorestown, NJ 08057-4215

Phone

(856) 638-5100

Fax

(856) 642-1582

NPI assigned

Dec 27, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Michael Dathan Booth

Title

V.P. Operations

Phone

(856) 638-5100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1482796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482796800000",
    "number": "1629513874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 COMMERCE DR",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080574215",
            "telephone_number": "856-638-5100",
            "fax_number": "856-642-1582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 COMMERCE DR",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080574215",
            "telephone_number": "856-638-5100",
            "fax_number": "856-642-1582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM CARE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-27",
        "last_updated": "2016-12-27",
        "status": "A",
        "authorized_official_last_name": "BOOTH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DATHAN",
        "authorized_official_title_or_position": "V.P. OPERATIONS",
        "authorized_official_telephone_number": "856-638-5100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NJ",
            "license": "HPO248300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pomac Metro Ipa LLC
• Pomac Metro LLC
• Pomac Usp
• Maria Irene Cokonis Poulathas, RPH
• Premise Health of New Jersey Medical PC (The Wellness Center Operated by Premise Health)
• Angela Marie Presner, BCBA
• Cheryl C. Pride I, MSW, LCSW
• Primary Care of Moorestown PC
• Princeton Medical Center (Princeton House)
• Private Duty Services of Partners in Home Care Inc.

• Home Health Agency in Moorestown, NJ
• Providers in Moorestown, NJ by specialty
• Home Health Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.