Provider Demographics
NPI:1508537242
Name:PRIME CARE HME, INC.
Entity Type:Organization
Organization Name:PRIME CARE HME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:SOTTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-478-6178
Mailing Address - Street 1:4708 SW 74TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4417
Mailing Address - Country:US
Mailing Address - Phone:786-478-6178
Mailing Address - Fax:305-964-7065
Practice Address - Street 1:4708 SW 74TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4417
Practice Address - Country:US
Practice Address - Phone:786-478-6178
Practice Address - Fax:305-964-7065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-22
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLM7NG5OtherBCBS OF FLORIDA
FL114228800Medicaid