Healthcare Provider Details

I. General information

NPI: 1215083092
Provider Name (Legal Business Name): PRIMECARE NURSING SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 E 2ND AVE SW
ROME GA
30161-3359
US

IV. Provider business mailing address

PO BOX 5441
ROME GA
30162-5441
US

V. Phone/Fax

Practice location:
  • Phone: 706-291-9151
  • Fax: 706-291-1447
Mailing address:
  • Phone: 706-291-9151
  • Fax: 706-291-1447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. JAMES J FUQUA
Title or Position: PRESIDENT & CEO
Credential:
Phone: 706-291-9151