Provider Demographics
NPI:1144412230
Name:PRYME CORP.
Entity Type:Organization
Organization Name:PRYME CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CPCI
Authorized Official - Phone:801-773-3826
Mailing Address - Street 1:546 S 450 E
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84015-1778
Mailing Address - Country:US
Mailing Address - Phone:801-773-3826
Mailing Address - Fax:801-773-3849
Practice Address - Street 1:580 E SOUTH WEBER DR
Practice Address - Street 2:
Practice Address - City:SOUTH WEBER
Practice Address - State:UT
Practice Address - Zip Code:84405-9206
Practice Address - Country:US
Practice Address - Phone:801-773-3826
Practice Address - Fax:801-773-3849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTN251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========NMedicaid