MEDICARE: PRIME HOME CARE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251C00000X	Developmentally Disabled Services Day Training Agency
2	3747P1801X	Personal Care Attendant
3	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1790357994
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME HOME CARE INC.

Provider Business Mailing Address
First Line	:	805 W PRICE RD STE C5
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78520-8381
Country	:	US
Telephone Number	:	956-579-4587
Fax Number	:

Provider Business Practice Location Address
First Line	:	805 W PRICE RD STE C5
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78520-8381
Country	:	US
Telephone Number	:	956-579-4587
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ASHA VARGHESE
Credential	:	RN
Telephone Number	:	956-579-4587

Provider Enumeration Date	:	07/15/2021
Last Update Date	:	12/08/2022

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