Prime Medical Center LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

PRIME MEDICAL CENTER LLC

Practice address

1917 Rose Coral Ave
Las Vegas, NV 89106-1807

Phone

(786) 870-2904

NPI assigned

Oct 12, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jorge Puebla Isaac

Title

Manager

Phone

(786) 870-2904

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749513600000",
    "number": "1043936990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1917 ROSE CORAL AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891061807",
            "telephone_number": "786-870-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-12",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A",
        "authorized_official_last_name": "PUEBLA ISAAC",
        "authorized_official_first_name": "JORGE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "786-870-2904"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prime Wave Franchising , Inc.
• Primecare DX LLC
• Primecare Facility
• Primecare Homehealth Agency,LLC

• Health Service Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Health Service Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.