# PRIME HEALTHCARE,LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578743704
- **Authorized official:** DR. BAI KANU M.D. (CEO)
- **Authorized official phone:** (301) 805-2500

## Contact information

- **Practice address:** 3233 SUPERIOR LN, B21, BOWIE, MD 20715-1920
- **Practice address phone:** (301) 805-2500
- **Practice address fax:** (301) 805-0114
- **Mailing address:** 3233 SUPERIOR LN, B21, BOWIE, MD 20715-1920
- **Mailing address phone:** (301) 805-2500
- **Mailing address fax:** (301) 805-0114

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | D0058580 | MD | Yes |

## Other

- **Enumeration date:** 11/05/2007
- **Last updated:** 12/10/2007