Provider Demographics
NPI:1841578499
Name:PRIMECARE HOME HEALTH INC.
Entity Type:Organization
Organization Name:PRIMECARE HOME HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEJIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-565-4630
Mailing Address - Street 1:3325 W BELMONT AVE
Mailing Address - Street 2:SECOND FLOOR REAR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-5512
Mailing Address - Country:US
Mailing Address - Phone:866-565-4630
Mailing Address - Fax:866-565-4630
Practice Address - Street 1:3325 W BELMONT AVE
Practice Address - Street 2:SECOND FLOOR REAR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-5512
Practice Address - Country:US
Practice Address - Phone:866-565-4630
Practice Address - Fax:866-565-4630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health