# PRIME CARE INC MAT-SU

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PRIME CARE INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1609128826
- **Legal business name:** PRIME CARE INC
- **Authorized official:** GANIYU SHITTU (PRESIDENT)
- **Authorized official phone:** (907) 727-4090

## Contact information

- **Practice address:** 701 E PARKS HWY STE 207, WASILLA, AK 99654-8164
- **Practice address phone:** (907) 727-4090
- **Mailing address:** PO BOX 211706, ANCHORAGE, AK 99521-1706
- **Mailing address phone:** (907) 727-4090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/11/2012
- **Last updated:** 10/11/2012