Provider Demographics
NPI:1255198966
Name:PRIGMORE, QUINTIN CHARLES
Entity type:Individual
Prefix:
First Name:QUINTIN
Middle Name:CHARLES
Last Name:PRIGMORE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:781 N HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44310-2025
Mailing Address - Country:US
Mailing Address - Phone:330-232-3852
Mailing Address - Fax:
Practice Address - Street 1:781 N HOWARD ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-2025
Practice Address - Country:US
Practice Address - Phone:330-232-3852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0000000251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health