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Contact Information

PRIMELIFE HEALTH AND WELLNESS
888 THACKERAY TRL STE 103
OCONOMOWOC, WI53066-4342
 Phone: 866-329-4264
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Integrative Medicine

202D00000X
 

Obesity Medicine

2083B0002X 84 Physician/Preventive Medicine
Indicates primary specialty

NPI Profile & details for PRIMELIFE HEALTH AND WELLNESS

NPI # 1265230601
LBN Legal business name PRIMELIFE HEALTH AND WELLNESS
Authorized official ERIC ELLIOT - (VICE PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 03/03/2025
Last updated 03/03/2025 - More than a year ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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