Organization
PREMIUM IN-HOME CARE LLC
Active
Other names
PREMIUM IN-HOME CARE LLC
Organization subpart
No
Provider details
NPI number
Authorized official
BASHEER HAJI MOHAMMAD (PRESIDENT)
(314) 827-9045
Entity
Organization
Contact information
Practice address
4065 S GRAND BLVD STE 100, SAINT LOUIS, MO 63118-3418
(314) 827-9045
(314) 657-0179
Mailing address
4065 S GRAND BLVD STE 100, SAINT LOUIS, MO 63118-3418
(314) 827-9045
(314) 657-0179
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
MO
253Z00000X
In Home Supportive Care Agency
—
MO
Other
Enumeration date
03/22/2012
Last updated
10/09/2020
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