Provider Demographics
NPI:1457516098
Name:PRIMEPLUS SENIOR CENTER
Entity type:Organization
Organization Name:PRIMEPLUS SENIOR CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:BATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-625-5857
Mailing Address - Street 1:P.O. BOX 9302
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-3356
Mailing Address - Country:US
Mailing Address - Phone:757-625-5857
Mailing Address - Fax:757-625-5858
Practice Address - Street 1:7300 NEWPORT AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-3356
Practice Address - Country:US
Practice Address - Phone:757-625-5857
Practice Address - Fax:757-625-5858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-23
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAERO 2008-170261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0087302706OtherDMAS - KEPRO