Primestone Healthcare LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PRIMESTONE HEALTHCARE LLC

Practice address

4116 82ND Ave N
Brooklyn Park, MN 55443-2509

Phone

(612) 407-4517

NPI assigned

Apr 18, 2020

Last updated

Apr 18, 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

Ayodeji Omosola, MBBS,CDIP,CCS

Title

Director

Phone

(612) 407-4517

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1587168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587168000000",
    "number": "1912527052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4116 82ND AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554432509",
            "telephone_number": "612-407-4517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4116 82ND AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554432509",
            "telephone_number": "612-407-4517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMESTONE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-18",
        "last_updated": "2020-04-18",
        "certification_date": "2020-04-18",
        "status": "A",
        "authorized_official_last_name": "OMOSOLA",
        "authorized_official_first_name": "AYODEJI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "612-407-4517",
        "authorized_official_credential": "MBBS,CDIP,CCS"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.