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General NPI Number Information
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NPI Number | 1336958289
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Entity Type | Organization
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Legal Business Name | PRIME ORTHO CARE LLC
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 123 MEDFORD AVE
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City | EAST PATCHOGUE
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State | NY
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Zip | 11772-1203
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Country | US
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Telephone | 929-653-1122
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Fax |
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Provider Business Mailing Address
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Address Line | 1652 MANATUCK BLVD
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City | BAY SHORE
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State | NY
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Zip | 11706-2149
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Country | US
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Telephone | 929-653-1122
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Fax | 832-284-9876
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Authorized Official
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Title or Position | FACILITY MANAGER
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Name | MR. SAM OSCAR
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Credential |
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Telephone | 929-653-1122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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