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General NPI Number Information
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NPI Number | 1114116951
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE, PLLC
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 07/29/2011
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Provider Practice Location Address
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Address Line | 4040 EST LA GRANDE PRINCESS SUITE 1
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City | CHRISTIANSTED
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State | VI
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Zip | 00820-5165
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Country | US
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Telephone | 340-718-7788
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Fax | 340-718-8978
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Provider Business Mailing Address
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Address Line | 4040 EST LA GRANDE PRINCESS SUITE 1
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City | CHRISTIANSTED
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State | VI
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Zip | 00820-5165
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Country | US
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Telephone | 340-718-7788
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Fax | 340-718-8978
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Authorized Official
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Title or Position | OWNER
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Name | DR. ARAKERE B PRASAD
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Credential | M.D., F.A.C.E.P.
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Telephone | 340-718-7788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 621
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License Number State | VI
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