Prime Care Services LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

PRIME CARE SERVICES LLC

Practice address

3526 N California Ave Ste a
Peoria, IL 61603-1143

Phone

(313) 758-9893

Fax

(313) 406-6790

NPI assigned

May 25, 2020

Last updated

May 25, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mouad Nagi Ali

Title

President

Phone

(313) 758-9893

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590364800000",
    "number": "1316560394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13800 WELLESLEY ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263529",
            "telephone_number": "313-758-9893",
            "fax_number": "313-406-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3526 N CALIFORNIA AVE STE A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616031143",
            "telephone_number": "313-758-9893",
            "fax_number": "313-406-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-25",
        "last_updated": "2020-05-25",
        "certification_date": "2020-05-25",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "MOUAD",
        "authorized_official_middle_name": "NAGI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-758-9893"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tabitha C Price, PTA
• Todd Richard Price, PTA
• Alexis Renee Priddy
• Jantzen Michelle Pride, MD
• James G. Priepot, M.D.
• Mandie Geneil Prior, DO
• Jacob Ryan Pritchard, LCPC
• Proctor Community Hospital (Proctor Hospital)
• Proctor Community Hospital (Proctor Hospital)
• Proctor Community Hospital

• Non-emergency Medical Transport (VAN) in Peoria, IL
• Providers in Peoria, IL by specialty
• Non-emergency Medical Transport (VAN) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.