# PRIME-CARE 12, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396843199
- **Authorized official:** DR. FLORENCIO PASCUAL NERI JR. M.D. (PRESIDENT)
- **Authorized official phone:** (304) 425-0085

## Contact information

- **Practice address:** 702 STAFFORD DR, PRINCETON, WV 24740-2406
- **Practice address phone:** (304) 425-0085
- **Practice address fax:** (304) 425-6283
- **Mailing address:** 702 STAFFORD DR, PRINCETON, WV 24740-2406
- **Mailing address phone:** (304) 425-0085
- **Mailing address fax:** (304) 487-6993

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 11431 | WV | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 02/03/2010