Healthcare Provider Details

I. General information

NPI: 1831025030
Provider Name (Legal Business Name): PRIMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 SWAN ST
SHERIDAN WY
82801-4151
US

IV. Provider business mailing address

30 N GOULD ST STE 65621
SHERIDAN WY
82801-6317
US

V. Phone/Fax

Practice location:
  • Phone: 251-332-4156
  • Fax: 214-646-2651
Mailing address:
  • Phone: 251-332-4156
  • Fax: 214-646-2651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: DAVID MARLEY
Title or Position: OWNER
Credential:
Phone: 251-332-4156