Provider Demographics
NPI:1740446673
Name:PRIME CARE MEDICAL SERVICES, INC.
Entity type:Organization
Organization Name:PRIME CARE MEDICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROMUALDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARAGON JR.
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-737-9520
Mailing Address - Street 1:1641 E FLAMINGO RD STE 11
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5257
Mailing Address - Country:US
Mailing Address - Phone:702-737-9520
Mailing Address - Fax:702-737-9522
Practice Address - Street 1:1641 E FLAMINGO RD STE 11
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5257
Practice Address - Country:US
Practice Address - Phone:702-737-9520
Practice Address - Fax:702-737-9522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-30
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9214207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty