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General NPI Number Information
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NPI Number | 1215083092
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Entity Type | Organization
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Legal Business Name | PRIMECARE NURSING SERVICES, INC.
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 700 E 2ND AVE SW
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City | ROME
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State | GA
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Zip | 30161-3359
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Country | US
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Telephone | 706-291-9151
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Fax | 706-291-1447
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Provider Business Mailing Address
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Address Line | PO BOX 5441
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City | ROME
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State | GA
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Zip | 30162-5441
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Country | US
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Telephone | 706-291-9151
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Fax | 706-291-1447
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MR. JAMES J FUQUA
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Credential |
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Telephone | 706-291-9151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | GA
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