MEDICARE: PRIMA HOME HEALTH LLC

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	251E00000X	Home Health Agency	HHA 299992155	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508835620
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMA HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	3500 N STATE ROAD 7
Second Line	:	SUITE 499
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-5600
Country	:	US
Telephone Number	:	954-731-4511
Fax Number	:	954-485-1082

Provider Business Practice Location Address
First Line	:	3500 N STATE ROAD 7
Second Line	:	SUITE 499
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-5600
Country	:	US
Telephone Number	:	954-731-4511
Fax Number	:	954-485-1082

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. BARRINGTON GEORGE COOMBS
Credential	:	C.P.A
Telephone Number	:	954-731-4511

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	09/10/2009

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Directions to “PRIMA HOME HEALTH LLC ” Practice Location

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