MEDICARE: PRIMERA HOME HEALTHCARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	135988	OH
2	213E00000X	Podiatrist	2825	OH

General Provider Information

NPI Number	:	1124001805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMERA HOME HEALTHCARE

Provider Business Mailing Address
First Line	:	450 W MAPLE ST
Second Line	:
City	:	HARTVILLE
State	:	OH
Zip	:	44632-9649
Country	:	US
Telephone Number	:	330-686-8317
Fax Number	:	330-686-8317

Provider Business Practice Location Address
First Line	:	450 W MAPLE ST
Second Line	:
City	:	HARTVILLE
State	:	OH
Zip	:	44632-9649
Country	:	US
Telephone Number	:	330-686-8317
Fax Number	:	330-686-8317

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAMES LAWRENCE CANTERBURY
Credential	:	D.P.M., R.N.
Telephone Number	:	330-686-8317

Provider Enumeration Date	:	11/27/2005
Last Update Date	:	09/11/2025

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Directions to “PRIMERA HOME HEALTHCARE ” Practice Location

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