Provider Demographics
NPI:1942550595
Name:PRIMECARE HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:PRIMECARE HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IMELDA
Authorized Official - Middle Name:Q
Authorized Official - Last Name:ESCOLAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-557-1747
Mailing Address - Street 1:301 GEORGIA ST
Mailing Address - Street 2:SUITE 325
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-5946
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:301 GEORGIA ST
Practice Address - Street 2:SUITE 325
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-5946
Practice Address - Country:US
Practice Address - Phone:707-557-1747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health