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General NPI Number Information
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NPI Number | 1285517938
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Entity Type | Organization
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Legal Business Name | PRIMUSU HEALTHCARE LLC
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Dates
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Enumeration Date | 07/29/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 1061 GREEN FAMILY RD
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City | CHARLESTON
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State | SC
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Zip | 29492-7788
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Country | US
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Telephone | 202-290-8763
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Fax |
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Provider Business Mailing Address
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Address Line | 1061 GREEN FAMILY RD
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City | CHARLESTON
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State | SC
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Zip | 29492-7788
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Country | US
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Telephone | 202-290-8763
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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. FATIMA GREEN
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Credential | CMA
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Telephone | 202-290-8763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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