Organization
PRIME TIME LIFE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIENNE BURFORD-FOGGS (MD/OWNER)
(844) 477-6543
Entity
Organization
Contact information
Practice address
207 E OHIO ST, CHICAGO, IL 60611-3238
(844) 477-6543
(888) 668-6550
Mailing address
676 N SAINT CLAIR ST, STE 2220, CHICAGO, IL 60611-2927
(844) 477-6543
(888) 668-6550
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/02/2016
Last updated
09/06/2016
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