Provider Demographics
NPI:1306478557
Name:PRIMARY HOME CARE, LLC
Entity type:Organization
Organization Name:PRIMARY HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHAMMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-843-2788
Mailing Address - Street 1:4937 W BROAD ST STE 305
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-1646
Mailing Address - Country:US
Mailing Address - Phone:614-843-2788
Mailing Address - Fax:614-417-5095
Practice Address - Street 1:4937 W BROAD ST STE 305
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-1646
Practice Address - Country:US
Practice Address - Phone:614-843-2788
Practice Address - Fax:614-417-5095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-05
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health