Provider Demographics
NPI:1023886884
Name:PRIME CHOICE HOME CARE LLC
Entity type:Organization
Organization Name:PRIME CHOICE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SABINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOMILOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-932-7737
Mailing Address - Street 1:1065 PRESERVE LN
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-5712
Mailing Address - Country:US
Mailing Address - Phone:404-932-7737
Mailing Address - Fax:
Practice Address - Street 1:1065 PRESERVE LN
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-5712
Practice Address - Country:US
Practice Address - Phone:404-932-7737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care