Primecare DME Supply Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PRIMECARE DME SUPPLY INC

Practice address

333 Gordon St
Suite a
Sanford, FL 32771-6325

Phone

(407) 585-0393

Fax

(407) 585-0396

NPI assigned

Oct 4, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Dale A Wallace

Title

President

Phone

(407) 585-0393

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033106208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 GORDON ST",
            "address_2": "SUITE A",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327716325",
            "telephone_number": "407-585-0393",
            "fax_number": "407-585-0396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 GORDON ST",
            "address_2": "SUITE A",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327716325",
            "telephone_number": "407-585-0393",
            "fax_number": "407-585-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMECARE DME SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-585-0393",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premise Health of Florida Medical PA (City of Sanford)
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• Prosthetic/Orthotic Supplier in Sanford, FL
• Providers in Sanford, FL by specialty
• Prosthetic/Orthotic Supplier in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.