MEDICARE: PRIME CARE SERVICES

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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1396369526
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME CARE SERVICES

Provider Business Mailing Address
First Line	:	1500 W 3RD AVE STE 206
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43212-2861
Country	:	US
Telephone Number	:	313-758-9893
Fax Number	:	313-406-6790

Provider Business Practice Location Address
First Line	:	1500 W 3RD AVE STE 206
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43212-2861
Country	:	US
Telephone Number	:	313-758-9893
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MOUAD ALI
Credential	:
Telephone Number	:	313-758-9893

Provider Enumeration Date	:	06/03/2020
Last Update Date	:	06/03/2020

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Directions to “PRIME CARE SERVICES ” Practice Location

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