Provider Demographics
NPI:1134941495
Name:PRIME ACCESS MEDICAL GROUP
Entity type:Organization
Organization Name:PRIME ACCESS MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ADOLPHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-930-8845
Mailing Address - Street 1:2300 PALM BEACH LAKES BLVD STE 218A
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-3308
Mailing Address - Country:US
Mailing Address - Phone:844-799-2213
Mailing Address - Fax:
Practice Address - Street 1:2300 PALM BEACH LAKES BLVD STE 218A
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-3308
Practice Address - Country:US
Practice Address - Phone:844-799-2213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies