Provider Demographics
NPI:1225381072
Name:PRIME HEALTHCARE SERVICES PAMPA LLC
Entity Type:Organization
Organization Name:PRIME HEALTHCARE SERVICES PAMPA LLC
Other - Org Name:WOMEN'S HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SARRAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-663-5663
Mailing Address - Street 1:100 W 30TH AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:PAMPA
Mailing Address - State:TX
Mailing Address - Zip Code:79065-2814
Mailing Address - Country:US
Mailing Address - Phone:806-663-5663
Mailing Address - Fax:
Practice Address - Street 1:100 W 30TH AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:PAMPA
Practice Address - State:TX
Practice Address - Zip Code:79065-2814
Practice Address - Country:US
Practice Address - Phone:806-663-5663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty