Premium in-Home Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PREMIUM IN-HOME CARE LLC

Doing business as

PREMIUM IN-HOME CARE LLC

Practice address

4065 S Grand Blvd Ste 100
Saint Louis, MO 63118-3418

Phone

(314) 827-9045

Fax

(314) 657-0179

NPI assigned

Mar 22, 2012

Organization subpart

No

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

Authorized official

Name

Basheer Haji Mohammad

Title

President

Phone

(314) 827-9045

Specialties & licenses 2

Addresses

Other names 1

• PREMIUM IN-HOME CARE LLC Doing business as

Locations

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602201600000",
    "number": "1699040725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4065 S GRAND BLVD STE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631183418",
            "telephone_number": "314-827-9045",
            "fax_number": "314-657-0179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4065 S GRAND BLVD STE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631183418",
            "telephone_number": "314-827-9045",
            "fax_number": "314-657-0179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM IN-HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-22",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A",
        "authorized_official_last_name": "HAJI MOHAMMAD",
        "authorized_official_first_name": "BASHEER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-827-9045"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MO",
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "MO",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PREMIUM IN-HOME CARE LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Home Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.