Prime Medical Supply Co., Inc.

Primary specialty

Nursing Facility Supplies (DME)Taxonomy code 332BN1400X

License

02995303 Issued in MD

Legal business name

PRIME MEDICAL SUPPLY CO., INC.

Practice address

3915 Benson Ave
Baltimore, MD 21227-1406

Phone

(410) 787-2069

Fax

(410) 787-0541

NPI assigned

Jun 30, 2005

Organization subpart

No

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

Authorized official

Name

Robert R Burns

Title

President

Phone

(410) 787-2069

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184716800000",
    "number": "1346247848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 BENSON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212271406",
            "telephone_number": "410-787-2069",
            "fax_number": "410-787-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 BENSON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212271406",
            "telephone_number": "410-787-2069",
            "fax_number": "410-787-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME MEDICAL SUPPLY CO., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2007-07-18",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-787-2069"
    },
    "taxonomies": [
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "MD",
            "license": "02995303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000030179",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0095150",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Primal Pointe Health LLC
• Primary Care at Home of Maryland, LLC
• Prime Care Transformation Organization, LLC (Prime CTO)
• Prime Clinical Associates, LLC (Prime Clinical Associates)
• Prime Health Care Agency Inc
• Primecare Pediatrics (Jay J Gopal MD)
• Primecare Pediatrics (Dr Jay Gopal MD)
• Primehealth Behavioral Healthcare Services LLC
• Primemed LLC
• Annelle B Primm, M.D.

• Nursing Facility Supplies (DME) in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Nursing Facility Supplies (DME) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.