Provider Demographics
NPI:1871548057
Name:PRIMED LLC
Entity type:Organization
Organization Name:PRIMED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:NEILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-638-1955
Mailing Address - Street 1:3554 HULMEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-4366
Mailing Address - Country:US
Mailing Address - Phone:215-638-1955
Mailing Address - Fax:
Practice Address - Street 1:3554 HULMEVILLE RD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-4366
Practice Address - Country:US
Practice Address - Phone:215-638-1955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031255E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC29616Medicare UPIN
PA084549Medicare ID - Type UnspecifiedPROVIDER ID