Healthcare Provider Details

I. General information

NPI: 1851321160
Provider Name (Legal Business Name): PRIMECARE MEDICAL TRANSPORT, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 05/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

568 MILFORD HARRINGTON HWY
MILFORD DE
19963-5306
US

IV. Provider business mailing address

568 MILFORD HARRINGTON HWY P.O. BOX 839
MILFORD DE
19963-5306
US

V. Phone/Fax

Practice location:
  • Phone: 302-422-0900
  • Fax: 302-422-1082
Mailing address:
  • Phone: 302-422-0900
  • Fax: 302-422-1082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1997113238
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number1997113238
License Number StateDE

VIII. Authorized Official

Name: MRS. KAREN R. FRY
Title or Position: CFO
Credential:
Phone: 302-422-0900