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NPI Code Detail

MEDICARE: PRIME TMS LLC

MEDICARE: PRIME TMS 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
1332900000XNon-Pharmacy Dispensing Site
2261QM0850XAdult Mental Health Clinic/Center

General Provider Information

NPI Number : 1891219911
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIME TMS LLC
Provider Business Mailing Address
First Line : 1811 WAKARUSA DR STE 102
Second Line :
City : LAWRENCE
State : KS
Zip : 66047-2082
Country : US
Telephone Number : 785-371-4921
Fax Number : 888-965-5147
Provider Business Practice Location Address
First Line : 1811 WAKARUSA DR STE 102
Second Line :
City : LAWRENCE
State : KS
Zip : 66047-2082
Country : US
Telephone Number : 785-371-4921
Fax Number : 888-965-4514
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : GARRETT HAGES
Credential :
Telephone Number : 785-371-4921
Provider Enumeration Date : 07/31/2017
Last Update Date : 08/01/2023

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Directions to “PRIME TMS LLC ” Practice Location

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