Healthcare Provider Details

I. General information

NPI: 1649525841
Provider Name (Legal Business Name): PRIME MEDICAL RESOURCES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2012
Last Update Date: 04/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 COMMERCE AVE STE. E
PALMDALE CA
93551-3881
US

IV. Provider business mailing address

1317 N SAN FERNANDO BLVD #315
BURBANK CA
91504-4236
US

V. Phone/Fax

Practice location:
  • Phone: 800-555-1051
  • Fax: 800-555-9161
Mailing address:
  • Phone: 800-555-1051
  • Fax: 800-555-9161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number55721
License Number StateCA

VIII. Authorized Official

Name: MRS. JOSSELYN ANDREA ROZO
Title or Position: CEO/PRESIDENT
Credential:
Phone: 818-568-6553