Provider Demographics
NPI:1831892314
Name:PRIMEDOC LLC
Entity type:Organization
Organization Name:PRIMEDOC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:ART
Authorized Official - Middle Name:
Authorized Official - Last Name:BEKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-940-0000
Mailing Address - Street 1:513 W BROAD ST STE 100
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3257
Mailing Address - Country:US
Mailing Address - Phone:703-940-0000
Mailing Address - Fax:
Practice Address - Street 1:513 W BROAD ST STE 100
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3257
Practice Address - Country:US
Practice Address - Phone:703-940-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-23
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty