Provider Demographics
NPI:1639330434
Name:PRIORITY HEALTHCARE LLC
Entity Type:Organization
Organization Name:PRIORITY HEALTHCARE LLC
Other - Org Name:DELPHINUS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:KASOR
Authorized Official - Last Name:GBATU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-506-0754
Mailing Address - Street 1:609 MIX AVE
Mailing Address - Street 2:# C
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-2354
Mailing Address - Country:US
Mailing Address - Phone:203-506-0754
Mailing Address - Fax:
Practice Address - Street 1:609 MIX AVE
Practice Address - Street 2:# C
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-2354
Practice Address - Country:US
Practice Address - Phone:203-506-0754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No253J00000XAgenciesFoster Care Agency