Provider Demographics
NPI:1578317434
Name:PRIMECARE CASTLE LLC
Entity Type:Organization
Organization Name:PRIMECARE CASTLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIGHT
Authorized Official - Middle Name:SAMSON
Authorized Official - Last Name:OLAYINKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-822-0057
Mailing Address - Street 1:5335 PRAIRIE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-3061
Mailing Address - Country:US
Mailing Address - Phone:929-822-0057
Mailing Address - Fax:
Practice Address - Street 1:5335 PRAIRIE CREEK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-3061
Practice Address - Country:US
Practice Address - Phone:929-822-0057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No251E00000XAgenciesHome Health
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies