Provider Demographics
NPI:1588790711
Name:PRIMARY HOUSE CALLS, INC.
Entity type:Organization
Organization Name:PRIMARY HOUSE CALLS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:LOCKE
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-764-2801
Mailing Address - Street 1:2703 DARBY DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-1521
Mailing Address - Country:US
Mailing Address - Phone:256-764-2801
Mailing Address - Fax:
Practice Address - Street 1:2703 DARBY DR
Practice Address - Street 2:SUITE B
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-1521
Practice Address - Country:US
Practice Address - Phone:256-764-2801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-036941363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty