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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 Facility114330TX

General Provider Information

NPI Number : 1972553337
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIME CARE SEVEN, LLC
Provider Business Mailing Address
First Line : 7900 WESTPARK DR
Second Line : T-900, ATTN: MEDICARE BILLING, M. GARCIA
City : MC LEAN
State : VA
Zip : 22102-4242
Country : US
Telephone Number : 703-854-0823
Fax Number : 703-854-0164
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 : EXECUTIVE DIRECTOR
Name : JIMMY CARTER
Credential :
Telephone Number : 210-930-1040
Provider Enumeration Date : 05/10/2006
Last Update Date : 06/18/2008

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Directions to “PRIME CARE SEVEN, LLC ” Practice Location

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