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
612 E DIXIE AVE, ELIZABETHTOWN, KY 42701-1077
(270) 982-5800
(888) 678-7191
Mailing address
555 E NORTH LN STE 5075, CONSHOHOCKEN, PA 19428-2490
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000069783
ANTHEM
KY
05
—
7100035230
—
KY
01
—
91022
APB
KY
01
—
MG0557
KENTUCKY BOARD OF PHARMACY LICENSE
KY
Enumeration date
07/02/2006
Last updated
10/15/2025
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