MEDICARE: PRIME LIFE LLC

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1972305142
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME LIFE LLC

Provider Business Mailing Address
First Line	:	2209 KELTRIP CT
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20906-1144
Country	:	US
Telephone Number	:	216-300-9474
Fax Number	:

Provider Business Practice Location Address
First Line	:	2209 KELTRIP CT
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20906-1144
Country	:	US
Telephone Number	:	216-300-9474
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	IHTESHAM KHAN
Credential	:
Telephone Number	:	216-300-9474

Provider Enumeration Date	:	03/26/2025
Last Update Date	:	05/16/2025

Similar Medicare Providers

1629933940 — MED AID LLC
Practice Location Address:

2209 KELTRIP CT
SILVER SPRING, MD
20906-1144

Practice Phone: 667-803-0636
Practice Fax:

1093811507 — MRS. LYNNE WASHINGTON STEVENS ME, CCC-SLP
Practice Location Address:

315 COLESVILLE MANOR DR
SILVER SPRING, MD
20904-1144

Practice Phone: 301-388-2211
Practice Fax: 301-388-2452

1023555356 — LAUREN VANVELSON
Practice Location Address:

113 MAPLE AVE
LITTLE SILVER, NJ
07739-1144

Practice Phone: 732-778-8738
Practice Fax:

1477614329 — EYESITE-ILLINOIS VALLEY, LLC
Practice Location Address:

215 RICHARD A MAUTINO DR
SPRING VALLEY, IL
61362-1144

Practice Phone: 815-664-5331
Practice Fax: 815-663-5057

1134272842 — KENT KUNKEL O.D.
Practice Location Address:

215 RICHARD A MAUTINO DR
SPRING VALLEY, IL
61362-1144

Practice Phone: 815-664-5331
Practice Fax: 815-663-5057

1912050527 — BETH KUNKEL O.D.
Practice Location Address:

215 RICHARD A MAUTINO DR
SPRING VALLEY, IL
61362-1144

Practice Phone: 815-664-5331
Practice Fax: 815-663-5057

Directions to “PRIME LIFE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.