| Prime Community Wellness Center Inc | |
|
3301 Baltusrol Ln Lake Worth FL 33467-1301 | |
| (561) 781-4255 | |
| Not Available |
| Full Name | Prime Community Wellness Center Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3301 Baltusrol Ln, Lake Worth, Florida |
| Authorized Official Name and Position | Jorge Dariel Ramos Sanchez (PRESIDENT) |
| Authorized Official Contact | 5617814255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Community Wellness Center Inc 3301 Baltusrol Ln Lake Worth FL 33467-1301 Ph: (561) 781-4255 | Prime Community Wellness Center Inc 3301 Baltusrol Ln Lake Worth FL 33467-1301 Ph: (561) 781-4255 |
| NPI Number | 1689254351 |
|---|---|
| Provider Enumeration Date | 04/08/2021 |
| Last Update Date | 04/08/2021 |
| Certification Date | 04/08/2021 |
| Medicare PECOS PAC ID | 8628433042 |
|---|---|
| Medicare Enrollment ID | O20230508000874 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689254351 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Roy C Musoff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104820745 PECOS PAC ID: 5799743399 Enrollment ID: I20041229000629 |
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