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General NPI Number Information
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NPI Number | 1679832729
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Entity Type | Organization
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Legal Business Name | PRIME MEDICAL CLINIC, PLC
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Dates
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Enumeration Date | 05/10/2012
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Last Update Date | 07/10/2014
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Provider Practice Location Address
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Address Line | 3104 E INDIAN SCHOOL RD SUITE 110
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City | PHOENIX
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State | AZ
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Zip | 85016-6889
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Country | US
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Telephone | 602-840-3584
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Fax | 602-957-2184
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Provider Business Mailing Address
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Address Line | 5150 N 16TH ST SUITE B232
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City | PHOENIX
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State | AZ
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Zip | 85016-3925
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Country | US
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Telephone | 602-840-3584
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Fax | 602-957-2184
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. PATRIC SCHINE
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Credential |
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Telephone | 602-840-3584
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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 | AP1483
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License Number State | AZ
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