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PRIME SOURCE MEDICAL SERVICES INC NPI 1902070964


NPI Information

NPI: 1902070964
Provider Name: PRIME SOURCE MEDICAL SERVICES, INC
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization
Address:
2715 MACKEY PL STE 116
SHREVEPORT, LA
ZIP 71118
Phone: (318) 687-6776
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PRIME SOURCE MEDICAL SERVICES, INC is a durable medical equipment medical supplies in Shreveport, LA. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. PRIME SOURCE MEDICAL SERVICES, INC NPI is 1902070964. The provider is registered as an organization entity type.

The provider's business location address is:

2715 MACKEY PL STE 116
SHREVEPORT, LA
ZIP 71118-528
Phone: (318) 687-6776
Fax: (318) 687-6996

The provider's authorized official is Jade U Irondi .
The authorized official title is President and has the following contact phone number (318) 687-6776.

The enumeration date for this NPI number is 4/21/2008 and was last updated on 4/21/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2332B00000XDurable Medical Equipment & Medical Supplies00213555LOUISIANAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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