Provider Demographics
NPI:1851560890
Name:PRIME HOMECARE AGENCY LLC
Entity Type:Organization
Organization Name:PRIME HOMECARE AGENCY LLC
Other - Org Name:ONCOLOGY HOMECARE
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:REEM
Authorized Official - Middle Name:
Authorized Official - Last Name:SATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-451-9400
Mailing Address - Street 1:44004 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48302-5031
Mailing Address - Country:US
Mailing Address - Phone:248-451-9400
Mailing Address - Fax:248-451-9401
Practice Address - Street 1:44004 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48302-5031
Practice Address - Country:US
Practice Address - Phone:248-451-9400
Practice Address - Fax:248-451-9401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health