MEDICARE: PRIMROSE 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1689274185
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMROSE INC

Provider Business Mailing Address
First Line	:	1349 LAKE ELMO DR
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59105-1759
Country	:	US
Telephone Number	:	406-601-1106
Fax Number	:	406-534-7645

Provider Business Practice Location Address
First Line	:	1349 LAKE ELMO DR
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59105-1759
Country	:	US
Telephone Number	:	406-601-1106
Fax Number	:	406-534-7645

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	HUNTER JACK JOHNSON
Credential	:
Telephone Number	:	406-633-1784

Provider Enumeration Date	:	10/26/2020
Last Update Date	:	10/26/2020

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Directions to “PRIMROSE INC ” Practice Location

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