MEDICARE: PRIME FINESSE 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	224P00000X	Prosthetist

General Provider Information

NPI Number	:	1689308355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME FINESSE LLC

Provider Business Mailing Address
First Line	:	5831 FORWARD AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15217-2301
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2217 CHALFANT ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15221-1250
Country	:	US
Telephone Number	:	412-999-3150
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LATISHA HINES
Credential	:
Telephone Number	:	412-999-3150

Provider Enumeration Date	:	07/10/2022
Last Update Date	:	07/10/2022

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Directions to “PRIME FINESSE LLC ” Practice Location

Language	Start Address	Practice Location

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