Provider Demographics
NPI:1104541390
Name:PRIME CARE MANAGERS, LLC
Entity type:Organization
Organization Name:PRIME CARE MANAGERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACO COORDINATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAUBLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:903-247-0525
Mailing Address - Street 1:4002 TECHNOLOGY CTR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-2697
Mailing Address - Country:US
Mailing Address - Phone:903-247-0525
Mailing Address - Fax:903-230-2709
Practice Address - Street 1:4002 TECHNOLOGY CTR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-2697
Practice Address - Country:US
Practice Address - Phone:903-247-0525
Practice Address - Fax:903-230-2709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-10
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty