Provider Demographics
NPI:1730878406
Name:PRIME HOME HEALTHCARE LLC
Entity type:Organization
Organization Name:PRIME HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SALIMATOU
Authorized Official - Middle Name:
Authorized Official - Last Name:JAWARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-814-5487
Mailing Address - Street 1:10910 LITTLE PATUXENT PKWY STE 204
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3092
Mailing Address - Country:US
Mailing Address - Phone:301-814-5487
Mailing Address - Fax:
Practice Address - Street 1:10910 LITTLE PATUXENT PKWY STE 204
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3092
Practice Address - Country:US
Practice Address - Phone:301-814-5487
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health