Healthcare Provider Details
I. General information
NPI: 1134043730
Provider Name (Legal Business Name): PRISM MEDICAL PRODUCTS, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6825 E TENNESSEE AVE STE 2-420
DENVER CO
80224-1628
US
IV. Provider business mailing address
PO BOX 476
ELKIN NC
28621-0476
US
V. Phone/Fax
- Phone: 888-244-6421
- Fax: 800-975-6321
- Phone: 888-244-6421
- Fax: 800-975-6321
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
ST CYR
Title or Position: VICE PRESIDENT AND GENERAL MANAGER
Credential:
Phone: 888-215-6405