Provider Demographics
NPI:1245085091
Name:PRIMARY HEALTH LABS LLC
Entity type:Organization
Organization Name:PRIMARY HEALTH LABS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEOVONNIA
Authorized Official - Middle Name:FELICIA
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED PHLEBOTOMY
Authorized Official - Phone:843-900-6768
Mailing Address - Street 1:1951 PISGAH RD # 12
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-6705
Mailing Address - Country:US
Mailing Address - Phone:843-900-6768
Mailing Address - Fax:
Practice Address - Street 1:1951 PISGAH RD # 12
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-6705
Practice Address - Country:US
Practice Address - Phone:843-900-6768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty