Healthcare Provider Details

I. General information

NPI: 1609411420
Provider Name (Legal Business Name): CAREPRIMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2019
Last Update Date: 11/13/2020
Certification Date: 11/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5979 E LIVINGSTON AVE STE 102
COLUMBUS OH
43232-2908
US

IV. Provider business mailing address

5979 E LIVINGSTON AVE STE 102
COLUMBUS OH
43232-2908
US

V. Phone/Fax

Practice location:
  • Phone: 614-300-0723
  • Fax:
Mailing address:
  • Phone: 614-300-0723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: PAULETTE HAMILTON
Title or Position: GENERAL MANAGER
Credential:
Phone: 614-300-0723