Healthcare Provider Details

I. General information

NPI: 1336059757
Provider Name (Legal Business Name): PRIME HEALTH CARE AGENCY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10538 BIRD RIVER RD
BALTIMORE MD
21220-1510
US

IV. Provider business mailing address

10538 BIRD RIVER RD
BALTIMORE MD
21220-1510
US

V. Phone/Fax

Practice location:
  • Phone: 443-600-1188
  • Fax:
Mailing address:
  • Phone: 443-600-1188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CHARLES IMARIABE III
Title or Position: DIRECTOR
Credential:
Phone: 443-600-1188