Organization
PRIME HEALTH MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAILA GOMAA M.D. (PRESIDENT)
(937) 291-2511
Entity
Organization
Contact information
Practice address
8120 GARNET DR, DAYTON, OH 45458-2141
(937) 291-2511
(937) 291-2523
Mailing address
8120 GARNET DR, DAYTON, OH 45458-2141
(937) 291-2511
(937) 291-2523
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1982
OH
207LP2900X
Pain Medicine (Anesthesiology) Physician
35-068963
OH
261QP3300X
Pain Clinic/Center
Primary
350868963G
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2032982
—
OH
Enumeration date
03/03/2008
Last updated
01/10/2011
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