Organization
PREMIER HOME CARE, INC
Active
Other names
AeroCare Home Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY RUSSALESI (CCO)
(484) 246-9499
Entity
Organization
Contact information
Practice address
404 S MAYO TRL, STE 9, PIKEVILLE, KY 41501
(606) 437-5562
(606) 437-5527
Mailing address
555 E NORTH LN STE 5075, CONSHOHOCKEN, PA 19428-2490
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000506316
ANTHEM ID
KY
01
—
400030
BLACK LUNG
KY
05
—
7100035190
—
KY
01
—
MG0571
KENTUCKY BOARD OF PHARMACY LICENSE
KY
Enumeration date
08/11/2006
Last updated
12/29/2025
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