Provider Demographics
NPI:1376192948
Name:PRIME CHOICE
Entity type:Organization
Organization Name:PRIME CHOICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGEMENT TEAM
Authorized Official - Prefix:
Authorized Official - First Name:AUTHORIZED
Authorized Official - Middle Name:
Authorized Official - Last Name:OFFICIAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-223-9385
Mailing Address - Street 1:805 ROSINANTE RD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79922-2915
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:805 ROSINANTE RD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79922-2915
Practice Address - Country:US
Practice Address - Phone:915-223-9385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-06
Last Update Date:2022-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health