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Organization

PRIME HOME HEALTHCARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MOHAMMED JAWARA PTA (VICE PRESIDENT)
(301) 404-4898
Entity
Organization

Contact information

Practice address
10910 LITTLE PATUXENT PKWY STE 204, COLUMBIA, MD 21044-3092
(301) 404-4898
(301) 901-5270
Mailing address
11434 HIGH HAY DR, COLUMBIA, MD 21044-1027
(301) 404-4898

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
225100000X
Physical Therapist
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist
251E00000X
Home Health Agency
Primary

Other

Enumeration date
03/25/2024
Last updated
03/25/2024
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