Provider Demographics
NPI:1982174553
Name:PRIME HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:PRIME HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-208-8366
Mailing Address - Street 1:2336 JOHN MCMILLAN RD
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348
Mailing Address - Country:US
Mailing Address - Phone:980-208-8366
Mailing Address - Fax:
Practice Address - Street 1:2336 JOHN MCMILLAN RD
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348
Practice Address - Country:US
Practice Address - Phone:980-208-8366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health