Provider Demographics
NPI:1679938203
Name:PRIME CARE HOME SERVICES LLC
Entity Type:Organization
Organization Name:PRIME CARE HOME SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:PENINNAH
Authorized Official - Middle Name:W
Authorized Official - Last Name:MUIRURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-428-3141
Mailing Address - Street 1:11 DEAN DR
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-1491
Mailing Address - Country:US
Mailing Address - Phone:781-428-3141
Mailing Address - Fax:
Practice Address - Street 1:140 WOOD RD STE 1007
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-2507
Practice Address - Country:US
Practice Address - Phone:781-428-3141
Practice Address - Fax:781-428-3183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-26
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health