Provider Demographics
NPI:1164480307
Name:PRIMECARE HOSPITALIST GROUP LLC
Entity Type:Organization
Organization Name:PRIMECARE HOSPITALIST GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMILA
Authorized Official - Middle Name:WYSE
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:813-991-1100
Mailing Address - Street 1:26838 TANIC DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-4617
Mailing Address - Country:US
Mailing Address - Phone:813-991-1100
Mailing Address - Fax:813-991-1200
Practice Address - Street 1:26838 TANIC DR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-4617
Practice Address - Country:US
Practice Address - Phone:813-991-1100
Practice Address - Fax:813-991-1200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty