Provider Demographics
NPI:1013801083
Name:PRIMECARE MEDICAL TRANSPORTATION LLC
Entity type:Organization
Organization Name:PRIMECARE MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDULRAHMAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:AL KHULAIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-684-4245
Mailing Address - Street 1:3209 N MAIN ST STE 107
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76106-5941
Mailing Address - Country:US
Mailing Address - Phone:559-705-3500
Mailing Address - Fax:
Practice Address - Street 1:3209 N MAIN ST STE 107
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76106-5941
Practice Address - Country:US
Practice Address - Phone:559-705-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)