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General NPI Number Information
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NPI Number | 1346694346
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Entity Type | Organization
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Legal Business Name | PRIME CARE HEALTH SERVICES INC
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Dates
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Enumeration Date | 04/16/2016
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Last Update Date | 11/29/2022
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Provider Practice Location Address
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Address Line | 451 E CARSON PLAZA DR STE 101
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City | CARSON
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State | CA
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Zip | 90746-3210
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Country | US
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Telephone | 310-418-5391
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Fax | 310-381-0039
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Provider Business Mailing Address
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Address Line | 451 E CARSON PLAZA DR STE 101
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City | CARSON
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State | CA
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Zip | 90746-3210
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Country | US
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Telephone | 424-558-3846
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Fax | 310-381-0039
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. AUGUSTINE CHIDEBE
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Credential |
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Telephone | 310-418-5391
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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 |
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Taxonomy #2
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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 | CA
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