Organization
PRIME HEALTH MEDICAL SUPPLIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLA ABUBAKAR (OPS MRG)
(718) 446-2300
Entity
Organization
Contact information
Practice address
8916 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372-7857
(718) 446-2300
(718) 446-2303
Mailing address
8916 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372-7857
(718) 446-2300
(718) 446-2303
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Enumeration date
03/08/2018
Last updated
03/08/2018
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