Provider Demographics
NPI:1891713764
Name:PRIORITY MEDICAL, INC.
Entity Type:Organization
Organization Name:PRIORITY MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUIZING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-376-5077
Mailing Address - Street 1:748 MORRIS TPKE STE 203
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-2617
Mailing Address - Country:US
Mailing Address - Phone:973-376-5077
Mailing Address - Fax:973-376-2615
Practice Address - Street 1:748 MORRIS TPKE STE 203
Practice Address - Street 2:
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078
Practice Address - Country:US
Practice Address - Phone:973-376-5077
Practice Address - Fax:973-376-2615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246Z00000X, 335E00000X
NJHP0105800332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0947860001Medicare NSC