Healthcare Provider Details

I. General information

NPI: 1922591908
Provider Name (Legal Business Name): PRIME CARE NURSES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2018
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4774 W COMMERCIAL BLVD
TAMARAC FL
33319-2878
US

IV. Provider business mailing address

4774 W COMMERCIAL BLVD
TAMARAC FL
33319-2878
US

V. Phone/Fax

Practice location:
  • Phone: 754-222-9999
  • Fax:
Mailing address:
  • Phone: 754-222-9999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GARRY ALEXIS
Title or Position: ADMINISTRATOR
Credential:
Phone: 754-222-9999