Organization Name: | PRIMETEAM, INC. |
NPI Number: | 1013199074 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRISTIE M MCLEAN (ADMINISTRATOR) |
Mailing Address: | 4126 West Main Street Dothan |
State: | AL US |
Postal Code: | 363059310 |
Phone Number: | 3347932120 |
Fax Number: | 3346712930 |
NPI Enumeration Date: | 12/03/2007 |
NPI Last Update Date: | 12/04/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |