Prime Medical, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

R2425 Issued in MD

Legal business name

PRIME MEDICAL, INC.

Practice address

8659 Baltimore National Pike
Suite Q
Ellicott City, MD 21043-4126

Phone

(410) 480-9007

Fax

(410) 480-9910

NPI assigned

Sep 27, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Bon Anele Agoha

Title

Administrator

Phone

(410) 480-9007

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346331527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8659 BALTIMORE NATIONAL PIKE",
            "address_2": "SUITE Q",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210434126",
            "telephone_number": "410-480-9007",
            "fax_number": "410-480-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8659 BALTIMORE NATIONAL PIKE",
            "address_2": "SUITE Q",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210434126",
            "telephone_number": "410-480-9007",
            "fax_number": "410-480-9910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AGOHA",
        "authorized_official_first_name": "BON",
        "authorized_official_middle_name": "ANELE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "410-480-9007",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MD",
            "license": "R2425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Durable Medical Equipment & Medical Supplies in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.