MEDICARE: PRIME CARE SERVICES INC

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)	L2752	MI

General Provider Information

NPI Number	:	1578830519
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME CARE SERVICES INC

Provider Business Mailing Address
First Line	:	2880 SALINA ST
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48120-1590
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2880 SALINA ST
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48120-1590
Country	:	US
Telephone Number	:	313-828-1009
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MOHAMED ALI
Credential	:
Telephone Number	:	313-828-1009

Provider Enumeration Date	:	11/18/2011
Last Update Date	:	11/18/2011

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Directions to “PRIME CARE SERVICES INC ” Practice Location

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