# PREMIUM CARE GROUP

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629513874
- **Authorized official:** MR. MICHAEL DATHAN BOOTH (V.P. OPERATIONS)
- **Authorized official phone:** (856) 638-5100

## Contact information

- **Practice address:** 301 COMMERCE DR, MOORESTOWN, NJ 08057-4215
- **Practice address phone:** (856) 638-5100
- **Practice address fax:** (856) 642-1582
- **Mailing address:** 301 COMMERCE DR, MOORESTOWN, NJ 08057-4215
- **Mailing address phone:** (856) 638-5100
- **Mailing address fax:** (856) 642-1582

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | HPO248300 | NJ | Yes |

## Other

- **Enumeration date:** 12/27/2016
- **Last updated:** 12/27/2016