Organization
PRODIGY MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERENICE I HALPIN (PARTNER)
(907) 299-3500
Entity
Organization
Contact information
Practice address
4107 HOHE ST, HOMER, AK 99603-7008
(907) 226-3400
(907) 226-3300
Mailing address
4107 HOHE ST, HOMER, AK 99603-7008
(907) 226-3400
(907) 226-3300
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
991850
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598711
—
AK
Enumeration date
06/02/2006
Last updated
12/30/2025
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