Provider Demographics
NPI:1992284574
Name:PRIMECARE NETWORK, INC.
Entity type:Organization
Organization Name:PRIMECARE NETWORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:IJEOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SONNY-ECHENDU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-400-5775
Mailing Address - Street 1:PO BOX 95
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-0095
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:312 S CHESTNUT ST STE 202
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-4270
Practice Address - Country:US
Practice Address - Phone:919-995-0554
Practice Address - Fax:252-429-7720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health