Prime Professional Home Health Inc

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PRIME PROFESSIONAL HOME HEALTH INC

Doing business as

Prime Professional Home Care

Practice address

13515A Lawing Dr
South Chesterfield, VA 23834-6018

Phone

(804) 892-0604

Fax

(804) 796-6257

NPI assigned

Dec 16, 2019

Organization subpart

No

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

Authorized official

Name

Simone Desiree King

Title

Owner

Phone

(804) 892-0604

Specialties & licenses 1

Addresses

Other names 1

• Prime Professional Home Care Doing business as

Locations

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

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576454400000",
    "number": "1528606068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13515A LAWING DR",
            "city": "SOUTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "238346018",
            "telephone_number": "804-892-0604",
            "fax_number": "804-796-6257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13515A LAWING DR",
            "city": "SOUTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "238346018",
            "telephone_number": "804-892-0604",
            "fax_number": "804-796-6257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME PROFESSIONAL HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-16",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "SIMONE",
        "authorized_official_middle_name": "DESIREE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-892-0604"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prime Professional Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• In Home Supportive Care Agency in South Chesterfield, VA
• Providers in South Chesterfield, VA by specialty
• In Home Supportive Care Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; 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.