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NPI Code Detail

MEDICARE: PRIME CARE SEVEN, LLC

MEDICARE: PRIME CARE SEVEN, 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
1314000000XSkilled Nursing FacilityPENDINGTX

General Provider Information

NPI Number : 1629025184
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIME CARE SEVEN, LLC
Provider Business Mailing Address
First Line : 10401 N MERIDIAN ST
Second Line : SUITE 122
City : INDIANAPOLIS
State : IN
Zip : 46290-1151
Country : US
Telephone Number : 317-630-3156
Fax Number : 317-630-3157
Provider Business Practice Location Address
First Line : 855 E BASSE RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78209-1890
Country : US
Telephone Number : 210-930-1040
Fax Number : 210-930-1844
Authorized Official
Title or Position : PRESIDENT
Name : JAY L HICKS
Credential :
Telephone Number : 317-630-3156
Provider Enumeration Date : 05/30/2006
Last Update Date : 08/22/2020

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Directions to “PRIME CARE SEVEN, LLC ” Practice Location

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