Healthcare Provider Details

I. General information

NPI: 1710812789
Provider Name (Legal Business Name): PRIMECARE MEDICAL SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 BOSTON ST
FORT SMITH AR
72901-6718
US

IV. Provider business mailing address

1317 EDGEWATER DR # 3291
ORLANDO FL
32804-6350
US

V. Phone/Fax

Practice location:
  • Phone: 223-214-6935
  • Fax:
Mailing address:
  • Phone: 223-214-6935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER NOLAN
Title or Position: MANAGER
Credential: MANAGER
Phone: 223-214-6935