Provider Demographics
NPI:1649525841
Name:PRIME MEDICAL RESOURCES, INC.
Entity type:Organization
Organization Name:PRIME MEDICAL RESOURCES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOSSELYN
Authorized Official - Middle Name:ANDREA
Authorized Official - Last Name:ROZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-568-6553
Mailing Address - Street 1:1317 N SAN FERNANDO BLVD
Mailing Address - Street 2:#315
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-4236
Mailing Address - Country:US
Mailing Address - Phone:800-555-1051
Mailing Address - Fax:800-555-9161
Practice Address - Street 1:530 COMMERCE AVE
Practice Address - Street 2:STE. E
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-3881
Practice Address - Country:US
Practice Address - Phone:800-555-1051
Practice Address - Fax:800-555-9161
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRIME HOLDINGS INTL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-13
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55721332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies