Provider Demographics
NPI:1538957675
Name:PRIMECARE SUPPLIES LLC
Entity type:Organization
Organization Name:PRIMECARE SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BEAGIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ERINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:093-749-2489
Mailing Address - Street 1:14405 RIO BONITO RD APT 382
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-1556
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14405 RIO BONITO RD APT 382
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-1556
Practice Address - Country:US
Practice Address - Phone:565-656-5656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies