Provider Demographics
NPI:1184982373
Name:PRIMARY PURPOSE LLC
Entity type:Organization
Organization Name:PRIMARY PURPOSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ADMINITRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:K
Authorized Official - Last Name:SOHR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-815-4967
Mailing Address - Street 1:2458 SW 42ND AVE
Mailing Address - Street 2:#3H
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33317-6934
Mailing Address - Country:US
Mailing Address - Phone:954-815-4967
Mailing Address - Fax:954-327-5810
Practice Address - Street 1:2458 SW 42ND AVE
Practice Address - Street 2:#3H
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33317-6934
Practice Address - Country:US
Practice Address - Phone:954-815-4967
Practice Address - Fax:954-327-8510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility