MEDICARE: PRIME MEDICAL SUPPLIES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1396613998
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME MEDICAL SUPPLIES INC.

Provider Business Mailing Address
First Line	:	1500 S CENTRAL AVE STE 323B
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-2530
Country	:	US
Telephone Number	:	747-200-5870
Fax Number	:	747-200-9475

Provider Business Practice Location Address
First Line	:	1500 S CENTRAL AVE STE 323B
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-2530
Country	:	US
Telephone Number	:	747-200-5870
Fax Number	:	747-200-9475

Authorized Official
Title or Position	:	HMDR EXEMPTEE
Name	:	ELEN BEREMESH
Credential	:	RN
Telephone Number	:	917-508-2682

Provider Enumeration Date	:	10/25/2025
Last Update Date	:	02/10/2026

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