Provider Demographics
NPI:1508685637
Name:PRIMECARE PRACTITIONERS LLC
Entity type:Organization
Organization Name:PRIMECARE PRACTITIONERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBRIANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:440-228-8302
Mailing Address - Street 1:5800 FLEET AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-3404
Mailing Address - Country:US
Mailing Address - Phone:440-228-8302
Mailing Address - Fax:440-484-5535
Practice Address - Street 1:5800 FLEET AVE STE 2
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-3404
Practice Address - Country:US
Practice Address - Phone:440-228-8302
Practice Address - Fax:440-484-5535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-07
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No282E00000XHospitalsLong Term Care Hospital
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility