Provider Demographics
NPI:1316560394
Name:PRIME CARE SERVICES LLC
Entity Type:Organization
Organization Name:PRIME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOUAD
Authorized Official - Middle Name:NAGI
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-758-9893
Mailing Address - Street 1:13800 WELLESLEY ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-3529
Mailing Address - Country:US
Mailing Address - Phone:313-758-9893
Mailing Address - Fax:313-406-6790
Practice Address - Street 1:3526 N CALIFORNIA AVE STE A
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61603-1143
Practice Address - Country:US
Practice Address - Phone:313-758-9893
Practice Address - Fax:313-406-6790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-25
Last Update Date:2020-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)