| NPI | 1093036154 |
|---|---|
| Doing Business As | PRIME MEDICAL GROUP - ROSTRAVER |
| Entity Type | Organization |
| Authorized Contact | KENNY HEINE VP Of Operations 858-625-2990 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: PA MD063217L) |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2013-12-16 |