Healthcare Provider Details

I. General information

NPI: 1174432736
Provider Name (Legal Business Name): PRIME CARE SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 SNYDER AVE STE 206
BROOKLYN NY
11226-8790
US

IV. Provider business mailing address

2301 SNYDER AVE STE 206
BROOKLYN NY
11226-8790
US

V. Phone/Fax

Practice location:
  • Phone: 332-251-1947
  • Fax:
Mailing address:
  • Phone: 332-251-1947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MISS ILONA MASHEYEVA
Title or Position: PRESEDENT
Credential:
Phone: 332-251-1947