Provider Demographics
NPI:1194234120
Name:PRIME MOBILE CARE INCORPORATED
Entity type:Organization
Organization Name:PRIME MOBILE CARE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:GENENE
Authorized Official - Middle Name:MARGIT
Authorized Official - Last Name:ESTRADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-450-3942
Mailing Address - Street 1:17515 W 9 MILE RD STE 375
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4404
Mailing Address - Country:US
Mailing Address - Phone:248-450-3942
Mailing Address - Fax:248-450-3946
Practice Address - Street 1:17515 W 9 MILE RD STE 375
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4404
Practice Address - Country:US
Practice Address - Phone:248-450-3942
Practice Address - Fax:248-450-3946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty