Organization
PRIME VIRTUAL CARE CENTER LLC
Active
Parent organization
PRIME VIRTUAL CARE CENTER LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIME VIRTUAL CARE CENTER LLC
Authorized official
SMITH JACKSON (MANAGER)
(520) 843-4567
Entity
Organization
Contact information
Practice address
165 ITHACA ST, BAY SHORE, NY 11706-4606
(520) 843-4567
Mailing address
165 ITHACA ST, BAY SHORE, NY 11706-4606
(520) 843-4567
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/19/2026
Last updated
06/19/2026
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