Organization
PRIME CARE MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLUGBENGA AWE MD (OWNER)
(912) 408-2555
Entity
Organization
Contact information
Practice address
825 W MARKET ST, LIMA, OH 45805-2799
(419) 331-9797
Mailing address
827 TIQUA TRL, LIMA, OH 45805-4705
(419) 331-9797
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35073659A
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2031607
—
OH
Enumeration date
09/06/2006
Last updated
08/22/2020
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