Organization
PRIME MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANE K. MADDOCK A.T.,C. (PRESIDENT/OWNER)
(406) 252-7225
Entity
Organization
Contact information
Practice address
1040 S 24TH ST W, BILLINGS, MT 59102-6406
(406) 252-7225
Mailing address
PO BOX 50305, BILLINGS, MT 59105-0305
(406) 252-7225
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0562094
—
MT
Enumeration date
08/02/2005
Last updated
08/14/2007
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