Organization
PHILADELPHIA PREMIUM HOMECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TALISHA THOMPSON (PRESIDENT)
(267) 808-9130
Entity
Organization
Contact information
Practice address
4619 LESHER ST, PHILADELPHIA, PA 19124-3321
(267) 808-9130
Mailing address
4619 LESHER ST, PHILADELPHIA, PA 19124-3321
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
06/03/2021
Last updated
06/03/2021
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