Provider Demographics
NPI:1710708441
Name:PRIME DIAGNOSTICS LLC
Entity type:Organization
Organization Name:PRIME DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIARA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-572-0252
Mailing Address - Street 1:5280 OLD SPRINGVILLE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PINSON
Mailing Address - State:AL
Mailing Address - Zip Code:35126-3600
Mailing Address - Country:US
Mailing Address - Phone:205-460-1083
Mailing Address - Fax:205-460-1083
Practice Address - Street 1:5280 OLD SPRINGVILLE RD STE 200
Practice Address - Street 2:
Practice Address - City:PINSON
Practice Address - State:AL
Practice Address - Zip Code:35126-3600
Practice Address - Country:US
Practice Address - Phone:205-460-1083
Practice Address - Fax:205-460-1083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty