PRODIGY MEDICAL LLC NPI 1073551131

NPI Information

NPI: 1073551131
Provider Name: PRODIGY MEDICAL, LLC
Classification: Durable Medical Equipment & Medical Supplies - 332BX2000X
Entity Type: Organization

Specialization: Oxygen Equipment & Supplies

Address:
4252 HOHE ST STE B
HOMER, AK
ZIP 99603
Phone: (907) 226-3400
Get Directions

PRODIGY MEDICAL, LLC is an oxygen equipment and supplies durable medical equipment medical supplies in Homer, AK. PRODIGY MEDICAL, LLC NPI is 1073551131. The provider is registered as an organization entity type.

The provider's business location address is:

4252 HOHE ST STE B
HOMER, AK
ZIP 99603-009
Phone: (907) 226-3400
Fax: (907) 226-3300

The provider's authorized official is Berenice I Halpin .
The authorized official title is Partner and has the following contact phone number (907) 299-3500.

The enumeration date for this NPI number is 6/2/2006 and was last updated on 10/30/2019.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332B00000X	Durable Medical Equipment & Medical Supplies				No
2	332BP3500X	Durable Medical Equipment & Medical Supplies	Parenteral & Enteral Nutrition			No
3	332BX2000X	Durable Medical Equipment & Medical Supplies	Oxygen Equipment & Supplies	991850	ALASKA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1598711	MEDICAID	ALASKA

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: 11/14/2023

NPI Synchronization or Removal

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