Provider Demographics
NPI:1497384127
Name:PRIME HEALTHSHARE
Entity Type:Organization
Organization Name:PRIME HEALTHSHARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-494-1380
Mailing Address - Street 1:251 IMPERIAL HWY STE 410
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-1058
Mailing Address - Country:US
Mailing Address - Phone:714-494-1380
Mailing Address - Fax:714-738-1238
Practice Address - Street 1:251 IMPERIAL HWY STE 410
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-1058
Practice Address - Country:US
Practice Address - Phone:714-494-1380
Practice Address - Fax:714-738-1238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-04
Last Update Date:2020-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies