Organization
PRIME HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IBRO TUCAKOVIC (MANAGING MEMBER)
(314) 544-0000
Entity
Organization
Contact information
Practice address
9700 MACKENZIE RD, SAINT LOUIS, MO 63123-5560
(314) 544-0000
Mailing address
9700 MACKENZIE RD, SAINT LOUIS, MO 63123-5560
(314) 544-0000
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
11/24/2021
Last updated
11/24/2021
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