Provider Demographics
NPI:1104336262
Name:PRIMA CARE HEALTH SERVICES
Entity type:Organization
Organization Name:PRIMA CARE HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROWLAND
Authorized Official - Middle Name:NGOZI
Authorized Official - Last Name:ACHUKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-804-5700
Mailing Address - Street 1:300 REISTERSTOWN RD STE 105
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-5330
Mailing Address - Country:US
Mailing Address - Phone:410-804-5700
Mailing Address - Fax:
Practice Address - Street 1:300 REISTERSTOWN RD STE 105
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-5330
Practice Address - Country:US
Practice Address - Phone:410-804-5700
Practice Address - Fax:410-484-0598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-03
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health