Provider Demographics
NPI:1568699700
Name:PRIMEMED, INC.
Entity Type:Organization
Organization Name:PRIMEMED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SIRAKANIAN
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:818-244-2100
Mailing Address - Street 1:311 N VERDUGO RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-3944
Mailing Address - Country:US
Mailing Address - Phone:818-244-2100
Mailing Address - Fax:818-244-2112
Practice Address - Street 1:311 N VERDUGO RD
Practice Address - Street 2:SUITE A
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-3944
Practice Address - Country:US
Practice Address - Phone:818-244-2100
Practice Address - Fax:818-244-2112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)