Provider Demographics
NPI:1992331557
Name:PRIME HOSPITALISTS LLC
Entity type:Organization
Organization Name:PRIME HOSPITALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:BERNAND
Authorized Official - Middle Name:
Authorized Official - Last Name:ADDO-QUAYE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-303-2770
Mailing Address - Street 1:1721 E CHARLESTON BLVD FL 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-1902
Mailing Address - Country:US
Mailing Address - Phone:702-685-0620
Mailing Address - Fax:702-685-9674
Practice Address - Street 1:1721 E CHARLESTON BLVD FL 3
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-1902
Practice Address - Country:US
Practice Address - Phone:026-850-6207
Practice Address - Fax:702-685-9674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-16
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1922009208Medicaid