Provider Demographics
NPI:1508341009
Name:PRIME MEDICAL HEALTH CENTER, INC
Entity Type:Organization
Organization Name:PRIME MEDICAL HEALTH CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:LULITA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCERO-UGALINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-337-1219
Mailing Address - Street 1:7210 FLAME LEAF CT
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-4093
Mailing Address - Country:US
Mailing Address - Phone:301-337-1219
Mailing Address - Fax:
Practice Address - Street 1:6B INDUSTRIAL PARK DRIVE
Practice Address - Street 2:UNIT 8
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20735-2073
Practice Address - Country:US
Practice Address - Phone:301-337-1219
Practice Address - Fax:888-472-0377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-01
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty