PRIME CARE MEDICAL CENTER LLC (NPI# 1821436155) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821436155 |
| Entity Type | Organization |
| Organization Name | PRIME CARE MEDICAL CENTER LLC |
| Practice Address |
203 W Lee St Tuskegee AL 36083-1719 |
| Mailing Address |
2220 Mt Vernon Ln Auburn AL 36830-4257 |
| Practice Telephone | 3346633587 |
| Practice Fax Number | 3348216287 |
| Mailing Telephone | 3348216287 |
| Enumeration Date | 2013-06-09 |
| Last Update Date | 2013-06-09 |
| Authorized Official Name | FAZLE MATIN (DIRECTOR) |
| Authorized Official Telephone | 3346633587 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
203 W LEE ST |
| City | TUSKEGEE |
| State | AL |
| Zip Code | 36083-1719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780736959 | Nelms, LLC | Pharmacist | 203 W Lee St, Tuskegee, AL 36083-1719 | 2007-01-17 |
| 1497197644 | Omega Drugs,llc | Pharmacy | 203 W Lee St, Tuskegee, AL 36083-1719 | 2013-07-29 |
| 1821430133 | Clinton Omega Adams | Pharmacist | 203 W Lee St, Tuskegee, AL 36083-1719 | 2013-07-28 |
| 1750607339 | Central Alabama Comprehensive Health Incorporated | Pharmacy | 203 W Lee St, Tuskegee, AL 36083-1719 | 2010-04-08 |
| 1518101161 | Tuskegee University Student Clinic | Clinic/Center | 203 W Lee St, Tuskegee University Campus, Tuskegee, AL 36083-1719 | 2009-04-27 |
| 1255504825 | Lakeisha Ashanti-joanna King | Nurse Practitioner | 203 W Lee St, Tuskegee, AL 36083-1719 | 2008-04-03 |
| 1497933980 | Glenda L Smith | Nurse Practitioner | 203 W Lee St, Tuskegee, AL 36083-1719 | 2008-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972698587 | Nguyet H Smith | Pharmacist | Central Alabama Veterans Health Care System, Pharmacy, 2400 Hospital Road, Tuskegee, AL 36083 | 2006-10-03 |
| 1619908795 | Carmen Elizabeth Beverly | Podiatrist | Cavhcs 2400 Hospital Rd, Dm Clinic, Tuskegee, AL 36083 | 2006-07-06 |
| 1275564635 | Tim Landers | Audiologist | 2400 Hospital Rd., Cavhcs - 126, Tuskegee, AL 36083 | 2006-07-05 |
| 1790726867 | Lasan Davis | Family Medicine | 203 West Lee Street, Tuskegee, AL 36083 | 2006-06-09 |
| 1831144344 | Denise Free Lensgraf-landers | Audiologist | Cavhcs Audiology (117), 2400 Hospital Road, Tuskegee, AL 36083 | 2006-05-23 |
| 1396705836 | Mark Patrick Mcguire | Optometrist | 2400 Hosptial Road, Eye Clinic Cavhcs, Tuskegee, AL 36083 | 2006-03-27 |
| 1164402863 | Lisa R Green | Optometrist | 2400 Hospital Rd Bldg 3, Tuskegee, AL 36083 | 2006-01-19 |
| 1265775936 | Shari Smith | Social Worker | 2400 Hospital Rd., Cavhcs- Social Work Services, Tuskegee, AL 36083 | 2013-04-01 |
| 1689902710 | Penny M Genous | Social Worker | 2400 Hospital Rd, Tuskegee, AL 36083 | 2009-12-01 |
| 1194954255 | Kevin Mcbeth Johnson | Student in an Organized Health Care Education/Training Program | 2400 Hospital Rd, Tuskegee, AL 36083 | 2009-07-10 |
| Find all providers in zip 36083 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316044365 | Krishnaswami Srinivasan | Clinic/Center | 2400 Hospital Rd, Tuskegee, AL 36083-5001 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891316758 | Modern Health Family Care Practice | Clinic/Center | 13000 Cottonwood Rd, Cottonwood, AL 36320-4280 | 2020-05-01 |
| 1487274650 | Faith Medical Clinic LLC | Clinic/Center | 64 Mccurdy Ave N, Rainsville, AL 35986-4465 | 2020-04-17 |
| 1386283471 | E A Mccleskey, Do, LLC | Clinic/Center | 103 Intercom Dr Ste B, Madison, AL 35758-2641 | 2020-01-06 |
| 1568012755 | Watchman's Health PC | Clinic/Center | 1501 7th St Se Ste A, Decatur, AL 35601-3375 | 2019-09-19 |
| 1184273096 | Spedale Md PC | Clinic/Center | 3113 Wesley Way Ste 1, Dothan, AL 36305-2004 | 2019-09-04 |
| 1124675459 | Mainstreet Family Care LLC | Clinic/Center | 1500 1st Ave N Unit 3, Birmingham, AL 35203-1866 | 2019-08-21 |
| 1568016004 | Fenton Chiropractic LLC | Clinic/Center | 301 1st St S, Reform, AL 35481-8013 | 2019-08-01 |
| 1568967081 | Bernice R Swain Do Pllc | Clinic/Center | 2424 Danville Rd Sw Ste L, Decatur, AL 35603-4219 | 2018-03-27 |
| 1578088001 | Coastal Health & Wellness | Clinic/Center | 14 Confederate Dr S, Spanish Fort, AL 36527-3062 | 2017-08-05 |
| 1760918494 | Killen Urgent Care, Inc. | Clinic/Center | 152 J C Mauldin Hwy, Killen, AL 35645-9106 | 2017-05-01 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PRIME CARE MEDICAL CENTER LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.