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General NPI Number Information
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NPI Number | 1104725712
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Entity Type | Organization
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Legal Business Name | MEDPRIME REVENUE LLC
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Dates
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Enumeration Date | 11/02/2026
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Last Update Date | 11/02/2026
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Provider Practice Location Address
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Address Line | 1331 PRINCESS DR
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City | STOCKTON
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State | CA
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Zip | 95209-1926
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Country | US
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Telephone | 201-479-1498
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Fax | 201-479-1498
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Provider Business Mailing Address
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Address Line | 1331 PRINCESS DR
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City | STOCKTON
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State | CA
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Zip | 95209-1926
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Country | US
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Telephone | 201-479-1498
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Fax | 201-479-1498
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Authorized Official
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Title or Position | OWNER
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Name | AKASHDEEP SINGH
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Credential |
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Telephone | 201-479-1498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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