Provider Demographics
NPI:1760367866
Name:PRIMAX WELLNESS GROUP INC
Entity type:Organization
Organization Name:PRIMAX WELLNESS GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHULEM
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-598-3195
Mailing Address - Street 1:409 EASTON RD
Mailing Address - Street 2:STE 203
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-2529
Mailing Address - Country:US
Mailing Address - Phone:347-598-3195
Mailing Address - Fax:
Practice Address - Street 1:409 EASTON RD
Practice Address - Street 2:SUITE 203
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-2529
Practice Address - Country:US
Practice Address - Phone:347-598-3195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty