Organization
PRIME ASSURE LLC
Active
Organization
PRIME ASSURE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ULOMA D ONUBOGU PHD., ARNP (MANAGER)
85085241577
Entity
Organization
Contact information
Practice address
1060 WINTER LN, TALLAHASSEE, FL 32311-1267
(850) 524-1577
Mailing address
1060 WINTER LN, TALLAHASSEE, FL 32311-1267
(850) 852-4157
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
2721822
FL
261QP2300X
Primary Care Clinic/Center
2721822
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009484200
—
FL
Enumeration date
06/16/2013
Last updated
10/25/2016
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