Provider Demographics
NPI:1205556016
Name:PRIMARYCARE@HOME
Entity type:Organization
Organization Name:PRIMARYCARE@HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:FLEMING
Authorized Official - Last Name:RINEHART
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:520-400-3184
Mailing Address - Street 1:30046 N VARNUM RD
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85143-7065
Mailing Address - Country:US
Mailing Address - Phone:520-400-3184
Mailing Address - Fax:480-999-4374
Practice Address - Street 1:30046 N VARNUM RD
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85143-7065
Practice Address - Country:US
Practice Address - Phone:520-400-3184
Practice Address - Fax:480-999-4374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility