| Prime Medical Health Center, Inc | |
|
6b Industrial Park Drive Unit 8 Waldorf MD 20735-2073 | |
| (301) 337-1219 | |
| (888) 472-0377 |
| Full Name | Prime Medical Health Center, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 6b Industrial Park Drive, Waldorf, Maryland |
| Authorized Official Name and Position | Lulita Lucero-ugalino (MD) |
| Authorized Official Contact | 3013371219 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Medical Health Center, Inc 7210 Flame Leaf Ct Clinton MD 20735-4093 Ph: (301) 337-1219 | Prime Medical Health Center, Inc 6b Industrial Park Drive Unit 8 Waldorf MD 20735-2073 Ph: (301) 337-1219 |
| NPI Number | 1508341009 |
|---|---|
| Provider Enumeration Date | 10/01/2018 |
| Last Update Date | 11/04/2020 |
| Medicare PECOS PAC ID | 1951642404 |
|---|---|
| Medicare Enrollment ID | O20190410000085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508341009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Lulita T Lucero-ugalino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841452687 PECOS PAC ID: 7113184995 Enrollment ID: I20141007000214 |
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