Provider Demographics
NPI:1063612828
Name:PRIME HEALTH ASSOCIATES DBA
Entity type:Organization
Organization Name:PRIME HEALTH ASSOCIATES DBA
Other - Org Name:<UNAVAIL>
Other - Org Type:
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 1:703 RITTER DR
Practice Address - Street 2:
Practice Address - City:GLEN MORGAN
Practice Address - State:WV
Practice Address - Zip Code:25813-7709
Practice Address - Country:US
Practice Address - Phone:304-255-1300
Practice Address - Fax:304-255-5391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV51D0235381291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory