Provider Demographics
NPI:1427597350
Name:PRIMECARE HOSPICE & PALLIATIVE INC
Entity Type:Organization
Organization Name:PRIMECARE HOSPICE & PALLIATIVE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CALEB
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOURNOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-755-1972
Mailing Address - Street 1:1735 IRWINTON RD STE 1A
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-3830
Mailing Address - Country:US
Mailing Address - Phone:770-755-1972
Mailing Address - Fax:478-451-0224
Practice Address - Street 1:1735 IRWINTON RD STE 1A
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-3830
Practice Address - Country:US
Practice Address - Phone:770-755-1972
Practice Address - Fax:478-451-0224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-12
Last Update Date:2023-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based