Provider Demographics
NPI:1275325094
Name:BLEDSOE PREMIER HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:BLEDSOE PREMIER HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALTHESIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLEDSOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-298-3164
Mailing Address - Street 1:165 W SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:MS
Mailing Address - Zip Code:38632-2265
Mailing Address - Country:US
Mailing Address - Phone:662-298-3164
Mailing Address - Fax:662-298-3219
Practice Address - Street 1:165 W SOUTH ST
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:MS
Practice Address - Zip Code:38632-2265
Practice Address - Country:US
Practice Address - Phone:662-298-3164
Practice Address - Fax:662-298-3219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health