| Prime-care 12, Inc | |
|
702 Stafford Dr Princeton WV 24740-2406 | |
| (304) 425-0085 | |
| (304) 425-6283 |
| Full Name | Prime-care 12, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 702 Stafford Dr, Princeton, West Virginia |
| Authorized Official Name and Position | Florencio Pascual Neri (PRESIDENT) |
| Authorized Official Contact | 3044250085 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime-care 12, Inc 702 Stafford Dr Princeton WV 24740-2406 Ph: (304) 425-0085 | Prime-care 12, Inc 702 Stafford Dr Princeton WV 24740-2406 Ph: (304) 425-0085 |
| NPI Number | 1396843199 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 02/03/2010 |
| Medicare PECOS PAC ID | 6406988591 |
|---|---|
| Medicare Enrollment ID | O20100726000511 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396843199 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 11431 (West Virginia) | Primary |
| Provider Name | Florencio P Neri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134118524 PECOS PAC ID: 0143351445 Enrollment ID: I20100630000714 |
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