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General NPI Number Information
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NPI Number | 1194597476
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Entity Type | Organization
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Legal Business Name | PRIMACARE, LLC
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Dates
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Enumeration Date | 10/30/2023
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 3806 WOOD HOLLOW WAY
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City | SNELLVILLE
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State | GA
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Zip | 30039-6080
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Country | US
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Telephone | 470-902-8400
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Fax | 770-783-6604
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Provider Business Mailing Address
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Address Line | 3806 WOOD HOLLOW WAY
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City | SNELLVILLE
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State | GA
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Zip | 30039-6080
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Country | US
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Telephone | 470-902-8400
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. RACQUEL TOOMER
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Credential | NP
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Telephone | 470-902-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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