Provider Demographics
NPI:1194125310
Name:PRIMARY HOME HEALTHCARE LLC
Entity type:Organization
Organization Name:PRIMARY HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:MBUGUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-241-4486
Mailing Address - Street 1:8 OTIS ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-1941
Mailing Address - Country:US
Mailing Address - Phone:508-241-4486
Mailing Address - Fax:508-310-9089
Practice Address - Street 1:251 W CENTRAL ST STE 27
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-3758
Practice Address - Country:US
Practice Address - Phone:508-241-4486
Practice Address - Fax:508-310-9089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-25
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health