Provider Demographics
NPI:1568589299
Name:PRIMEWAY HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:PRIMEWAY HEALTHCARE SERVICES
Other - Org Name:PRIMEWAY HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:N
Authorized Official - Last Name:OGIDI
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:281-403-4500
Mailing Address - Street 1:2440 TEXAS PKWY STE 226
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-4205
Mailing Address - Country:US
Mailing Address - Phone:281-403-4500
Mailing Address - Fax:
Practice Address - Street 1:2440 TEXAS PKWY STE 226
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-4205
Practice Address - Country:US
Practice Address - Phone:281-403-4500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009301251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX009301OtherLICENSE NUMBER
TX009301OtherLICENSE NUMBER