MEDICARE: PRIME CARE MEDICAL SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	9214	NV

General Provider Information

NPI Number	:	1740446673
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME CARE MEDICAL SERVICES, INC.

Provider Business Mailing Address
First Line	:	1641 E FLAMINGO RD STE 11
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5257
Country	:	US
Telephone Number	:	702-737-9520
Fax Number	:	702-737-9522

Provider Business Practice Location Address
First Line	:	1641 E FLAMINGO RD STE 11
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5257
Country	:	US
Telephone Number	:	702-737-9520
Fax Number	:	702-737-9522

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ROMUALDO A ARAGON JR.
Credential	:	M.D.
Telephone Number	:	702-737-9520

Provider Enumeration Date	:	07/30/2008
Last Update Date	:	10/14/2020

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