Provider Demographics
NPI:1104025741
Name:PRIME HEALTH ASSOCIATES DBA
Entity Type:Organization
Organization Name:PRIME HEALTH ASSOCIATES DBA
Other - Org Name:CRAB ORCHARD FAMILY HEALTHCARE (LAB)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZINZUWADIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-255-1300
Mailing Address - Street 1:PO BOX 1074
Mailing Address - Street 2:
Mailing Address - City:CRAB ORCHARD
Mailing Address - State:WV
Mailing Address - Zip Code:25827-1074
Mailing Address - Country:US
Mailing Address - Phone:304-252-0966
Mailing Address - Fax:304-252-4615
Practice Address - Street 1:1315 ROBERT C. BYRD DRIVE
Practice Address - Street 2:
Practice Address - City:CRAB ORCHARD
Practice Address - State:WV
Practice Address - Zip Code:25827
Practice Address - Country:US
Practice Address - Phone:304-252-0966
Practice Address - Fax:304-252-4615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV51D0235448291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory