Provider Demographics
NPI:1437683422
Name:PRIORITY MEDICAL SUPPLY, INCORPORATED
Entity Type:Organization
Organization Name:PRIORITY MEDICAL SUPPLY, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GAVIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-702-4364
Mailing Address - Street 1:2425 NOSTRAND AVE
Mailing Address - Street 2:SUITE 501
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4056
Mailing Address - Country:US
Mailing Address - Phone:917-702-4364
Mailing Address - Fax:718-228-6916
Practice Address - Street 1:2425 NOSTRAND AVE
Practice Address - Street 2:SUITE 501
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-4056
Practice Address - Country:US
Practice Address - Phone:917-702-4364
Practice Address - Fax:718-228-6916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies