Organization
PRIME SURGICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VADIM POVZLOV (PRESIDENT)
(718) 891-2000
Entity
Organization
Contact information
Practice address
2105 AVENUE U, BROOKLYN, NY 11229-3609
(718) 891-2000
(718) 891-2209
Mailing address
2105 AVENUE U, BROOKLYN, NY 11229-3609
(718) 891-2000
(718) 891-2209
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1136374
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02781919
—
NY
Enumeration date
10/16/2006
Last updated
07/23/2007
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