Healthcare Provider Details

I. General information

NPI: 1881517670
Provider Name (Legal Business Name): PRIMEACCESS SUPPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4638 CUMBERLAND LOOP
BISMARCK ND
58503-5037
US

IV. Provider business mailing address

4638 CUMBERLAND LOOP
BISMARCK ND
58503-5037
US

V. Phone/Fax

Practice location:
  • Phone: 701-651-5323
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: VICTOR NAHIMANA
Title or Position: CEO
Credential:
Phone: 701-651-5323