Organization
PRIME CARE SERVICES INCORPORATED
Active
Organization
PRIME CARE SERVICES INCORPORATED
Active
Other names
Prime Home Care Incorporated
Organization subpart
No
Provider details
NPI number
Authorized official
EDOLO AZENABOR (ADMINISTRATOR)
(214) 418-8240
Entity
Organization
Contact information
Practice address
2306 OAK LN STE 206, GRAND PRAIRIE, TX 75051-8270
(214) 418-8240
(972) 262-6544
Mailing address
2306 OAK LN STE 206, GRAND PRAIRIE, TX 75051-8270
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
03/27/2013
Last updated
01/20/2021
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