Provider Demographics
NPI:1518512318
Name:PRIMARY CARE HEALTH INC.
Entity Type:Organization
Organization Name:PRIMARY CARE HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUEY
Authorized Official - Suffix:
Authorized Official - Credentials:BSHCA
Authorized Official - Phone:702-528-9947
Mailing Address - Street 1:1312 PAGENTRY DR
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-2340
Mailing Address - Country:US
Mailing Address - Phone:702-528-9947
Mailing Address - Fax:702-522-1606
Practice Address - Street 1:4375 LAS VEGAS BLVD N STE 9
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89115-0587
Practice Address - Country:US
Practice Address - Phone:702-450-1717
Practice Address - Fax:702-522-1606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty