Provider Demographics
NPI:1013199074
Name:PRIMETEAM, INC.
Entity Type:Organization
Organization Name:PRIMETEAM, INC.
Other - Org Name:PRIMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-793-2120
Mailing Address - Street 1:PO BOX 8397
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36304-0397
Mailing Address - Country:US
Mailing Address - Phone:334-793-2120
Mailing Address - Fax:334-671-2930
Practice Address - Street 1:4126 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-9310
Practice Address - Country:US
Practice Address - Phone:334-793-2120
Practice Address - Fax:334-671-2930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care