Provider Demographics
NPI:1992330443
Name:PRIMARY MEDICAL SERVICES, LLC
Entity type:Organization
Organization Name:PRIMARY MEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-748-0049
Mailing Address - Street 1:PO BOX 1708
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-1708
Mailing Address - Country:US
Mailing Address - Phone:973-748-0049
Mailing Address - Fax:973-743-0026
Practice Address - Street 1:14-20 WATSESSING AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-4611
Practice Address - Country:US
Practice Address - Phone:973-748-0049
Practice Address - Fax:973-743-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty