Provider Demographics
NPI:1467698340
Name:PRIORITY HEALTH CARE SERVICES INC.
Entity Type:Organization
Organization Name:PRIORITY HEALTH CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:T
Authorized Official - Last Name:ANYAKWO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-461-5290
Mailing Address - Street 1:2023 W COMPTON BLVD
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90220-1312
Mailing Address - Country:US
Mailing Address - Phone:310-461-5290
Mailing Address - Fax:
Practice Address - Street 1:2023 W COMPTON BLVD
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-1312
Practice Address - Country:US
Practice Address - Phone:310-461-5290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-26
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization