Provider Demographics
NPI:1356752620
Name:PRIMERA HEALTHCARE SOLUTIONS, INC.
Entity type:Organization
Organization Name:PRIMERA HEALTHCARE SOLUTIONS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SOHRAB
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYAR
Authorized Official - Suffix:
Authorized Official - Credentials:MS-RRT
Authorized Official - Phone:847-586-0682
Mailing Address - Street 1:3340 DUNDEE RD STE 2C4
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2331
Mailing Address - Country:US
Mailing Address - Phone:847-586-0682
Mailing Address - Fax:
Practice Address - Street 1:3340 DUNDEE RD STE 2C4
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2331
Practice Address - Country:US
Practice Address - Phone:847-586-0682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL194009157293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory