Provider Demographics
NPI:1518503366
Name:PRIME HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:PRIME HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RAMANJEET
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-722-0027
Mailing Address - Street 1:11890 SUNRISE VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-3302
Mailing Address - Country:US
Mailing Address - Phone:571-722-0727
Mailing Address - Fax:
Practice Address - Street 1:11890 SUNRISE VALLEY DR
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-3302
Practice Address - Country:US
Practice Address - Phone:571-722-0727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-26
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health