Organization
PRIMERA HEALTH AND WELLNESS COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAILESH SUSHIL KOTHARI (OWNER)
(678) 904-7564
Entity
Organization
Contact information
Practice address
130 7TH AVE, SUITE 312, NEW YORK, NY 10011-1803
(678) 904-7564
Mailing address
20430 N 19TH AVE, PHOENIX, AZ 85027-3588
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
04/20/2017
Last updated
04/20/2017
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