Provider Demographics
NPI:1639959984
Name:PRIME CARE MED SUPPLIES INC
Entity Type:Organization
Organization Name:PRIME CARE MED SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAKOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-391-3379
Mailing Address - Street 1:700 ROCKAWAY TPKE STE 401
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1014
Mailing Address - Country:US
Mailing Address - Phone:646-391-3379
Mailing Address - Fax:516-217-6541
Practice Address - Street 1:700 ROCKAWAY TPKE STE 401
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-1014
Practice Address - Country:US
Practice Address - Phone:646-391-3379
Practice Address - Fax:516-217-6541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies