Priority Care Provider, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

CER-00125254 Issued in PA

Legal business name

PRIORITY CARE PROVIDER, LLC

Practice address

1000 Gum PL Apt a
Huntingdon Valley, PA 19006-1716

Phone

(267) 254-4553

Fax

(215) 893-5231

NPI assigned

Apr 29, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Mark Nimchuk, DPT

Title

Ceo

Phone

(267) 254-4553

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1524960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524960000000",
    "number": "1629566203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 LAWRENCE RD",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190062334",
            "telephone_number": "267-254-4553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 GUM PL APT A",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190061716",
            "telephone_number": "267-254-4553",
            "fax_number": "215-893-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIORITY CARE PROVIDER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-29",
        "last_updated": "2018-04-29",
        "status": "A",
        "authorized_official_last_name": "NIMCHUK",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "267-254-4553",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "CER-00125254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Huntingdon Valley, PA
• Providers in Huntingdon Valley, PA by specialty
• Community/Behavioral Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2018; 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.