Provider Demographics
NPI:1376840827
Name:PRIME MEDICAL CARE, P.C.
Entity Type:Organization
Organization Name:PRIME MEDICAL CARE, P.C.
Other - Org Name:ULTIMA MEDICAL & AESTHETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LALARUKH
Authorized Official - Middle Name:R
Authorized Official - Last Name:MALIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-686-1122
Mailing Address - Street 1:19735 GERMANTOWN RD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-1214
Mailing Address - Country:US
Mailing Address - Phone:240-686-1122
Mailing Address - Fax:240-686-1124
Practice Address - Street 1:19735 GERMANTOWN RD
Practice Address - Street 2:SUITE 280
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-1214
Practice Address - Country:US
Practice Address - Phone:240-686-1122
Practice Address - Fax:240-686-1124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0066741261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0066741OtherMEDICAL LICENSE
1740497601OtherNPI
BM9282144OtherDEA