MEDICARE: PRIME MEDICAL AND WELLNESS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1417884321
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME MEDICAL AND WELLNESS LLC

Provider Business Mailing Address
First Line	:	PO BOX 31161
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73003-0020
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2133 N KELLY AVE STE 100
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73003-0037
Country	:	US
Telephone Number	:	405-315-2752
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NITIN SAWHENY
Credential	:	MD
Telephone Number	:	405-795-2119

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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Directions to “PRIME MEDICAL AND WELLNESS LLC ” Practice Location

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