MEDICARE: PRIMEWELL VENTURES INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	164W00000X	Licensed Practical Nurse
2	253Z00000X	In Home Supportive Care Agency
3	374U00000X	Home Health Aide
4	225X00000X	Occupational Therapist
5	225100000X	Physical Therapist
6	163W00000X	Registered Nurse
7	376K00000X	Nurse's Aide
8	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1437009420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMEWELL VENTURES INC

Provider Business Mailing Address
First Line	:	100 INDEPENDENCE DR STE 7-918
Second Line	:
City	:	HYANNIS
State	:	MA
Zip	:	02601-1898
Country	:	US
Telephone Number	:	781-999-0204
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 MILITIA DR STE 202
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02421-4708
Country	:	US
Telephone Number	:	781-999-0204
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GRACE MUTOONI
Credential	:
Telephone Number	:	781-999-0204

Provider Enumeration Date	:	01/30/2026
Last Update Date	:	01/30/2026

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