Healthcare Provider Details

I. General information

NPI: 1316679293
Provider Name (Legal Business Name): PRIME QUALITY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 07/26/2023
Certification Date: 07/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16702 31ST AVE S APT 121
SEATAC WA
98188-3182
US

IV. Provider business mailing address

16702 31ST AVE S APT 121
SEATAC WA
98188-3182
US

V. Phone/Fax

Practice location:
  • Phone: 206-503-7699
  • Fax:
Mailing address:
  • Phone: 206-503-7699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ABDIRAHMAN O HERSI
Title or Position: CEO
Credential:
Phone: 206-503-7699