Provider Demographics
NPI:1891761615
Name:PRIME MEDICAL SUPPLY CORP
Entity Type:Organization
Organization Name:PRIME MEDICAL SUPPLY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NADLAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-437-0066
Mailing Address - Street 1:5723 NEW UTRECHT AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219
Mailing Address - Country:US
Mailing Address - Phone:718-437-0066
Mailing Address - Fax:718-437-0088
Practice Address - Street 1:5723 NEW UTRECHT AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219
Practice Address - Country:US
Practice Address - Phone:718-437-0066
Practice Address - Fax:718-437-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
316407OtherFAMILY HEALT
ANC0029OtherMHS
NY01566485Medicaid
A882469OtherOXFORD
ANC0029OtherMHS