Healthcare Provider Details

I. General information

NPI: 1548367063
Provider Name (Legal Business Name): PRISM MEDICAL PRODUCTS, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2006
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 CHURCH ST STE 101
ELKIN NC
28621-3476
US

IV. Provider business mailing address

PO BOX 476
ELKIN NC
28621-0476
US

V. Phone/Fax

Practice location:
  • Phone: 888-244-6421
  • Fax: 800-975-6321
Mailing address:
  • Phone: 888-244-6421
  • Fax: 800-975-6321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier112645100
Identifier TypeMEDICAID
Identifier StateFL
Identifier IssuerFlorida Medicaid Provider ID

VIII. Authorized Official

Name: CHRISTOPHER JON CARTWRIGHT
Title or Position: PRESIDENT
Credential:
Phone: 888-244-6421