Healthcare Provider Details

I. General information

NPI: 1114116951
Provider Name (Legal Business Name): PRIMARY CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 07/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4040 EST LA GRANDE PRINCESS SUITE 1
CHRISTIANSTED VI
00820-5165
US

IV. Provider business mailing address

4040 EST LA GRANDE PRINCESS SUITE 1
CHRISTIANSTED VI
00820-5165
US

V. Phone/Fax

Practice location:
  • Phone: 340-718-7788
  • Fax: 340-718-8978
Mailing address:
  • Phone: 340-718-7788
  • Fax: 340-718-8978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number621
License Number StateVI

VIII. Authorized Official

Name: DR. ARAKERE B PRASAD
Title or Position: OWNER
Credential: M.D., F.A.C.E.P.
Phone: 340-718-7788