Provider Demographics
NPI:1902897663
Name:PRIME HEALTH ASSOCIATES
Entity Type:Organization
Organization Name:PRIME HEALTH ASSOCIATES
Other - Org Name:CRAB ORCHARD FAMILY HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZINZUWADIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-255-1300
Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:WV
Mailing Address - Zip Code:25813-0550
Mailing Address - Country:US
Mailing Address - Phone:304-255-1300
Mailing Address - Fax:304-255-5391
Practice Address - Street 1:1315 ROBERT C BYRD DR
Practice Address - Street 2:
Practice Address - City:CRAB ORCHARD
Practice Address - State:WV
Practice Address - Zip Code:25827-4000
Practice Address - Country:US
Practice Address - Phone:304-252-0966
Practice Address - Fax:304-252-4615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-02
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV9357561Medicare PIN