Prime Enterprise, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

333542 Issued in MN

Legal business name

PRIME ENTERPRISE, INC.

Practice address

505 Janesville St NE
Fridley, MN 55432-1638

Phone

(952) 451-4941

NPI assigned

Oct 18, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Osetohame Agene, RN

Title

President/Owner

Phone

(952) 451-4941

Specialties & licenses 1

Addresses

Other names 1

• PRIME ENTERPRISE, INC. Doing business as

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508947169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 JANESVILLE ST NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554321638",
            "telephone_number": "952-451-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 JANESVILLE ST NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554321638",
            "telephone_number": "952-451-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME ENTERPRISE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AGENE",
        "authorized_official_first_name": "OSETOHAME",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "952-451-4941",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "333542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRIME ENTERPRISE, INC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scott Paul Prawer, MD
• Steven E Prawer, M.D.
• Premise Health of Minnesota Medical PC
• Janet Lynn Price, M.D.
• Pride N Living Home Care Inc .
• Abdirahim Yaasiin Qaybdid
• Asia Yaasin Qaybdid
• Naima Yaasiin Qaybdid
• R.PH.S Direct PLLC
• Ilhan A Raage

• Assisted Living Facility in Fridley, MN
• Providers in Fridley, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.