| NPI | 1124353339 |
|---|---|
| Doing Business As | PRIMARY MEDICAL HEALTHCARE PRACTICE |
| Entity Type | Organization |
| Authorized Contact | REDA COSTON Healthcare Administration Executive 404-800-5550 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine | |
| 251J00000X Nursing Care | |
| 251S00000X Community/Behavioral Health | |
| 261Q00000X | |
| 302R00000X Health Maintenance Organization | |
| 305R00000X Preferred Provider Organization | |
| Enumeration Date | 2009-10-06 |
| Last Update Date | 2020-07-16 |