Provider Demographics
NPI:1215083092
Name:PRIMECARE NURSING SERVICES, INC.
Entity type:Organization
Organization Name:PRIMECARE NURSING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:FUQUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-291-9151
Mailing Address - Street 1:PO BOX 5441
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30162-5441
Mailing Address - Country:US
Mailing Address - Phone:706-291-9151
Mailing Address - Fax:706-291-1447
Practice Address - Street 1:700 E 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-3359
Practice Address - Country:US
Practice Address - Phone:706-291-9151
Practice Address - Fax:706-291-1447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health