Organization
PREMIUM HOME HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS JOHNSON (OWNER)
(314) 379-9187
Entity
Organization
Contact information
Practice address
1921 CORA AVE, SAINT LOUIS, MO 63113-2223
(314) 379-9187
Mailing address
922 SOUTHERNSIDE LN, O FALLON, MO 63368-8433
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
07/15/2025
Last updated
07/15/2025
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