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General NPI Number Information
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NPI Number | 1699183350
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Entity Type | Organization
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Legal Business Name | PRISM HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 07/25/2014
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 6971 BUSINESS PARK BLVD N
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City | JACKSONVILLE
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State | FL
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Zip | 32256-2777
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Country | US
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Telephone | 904-880-9900
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Fax | 904-880-3241
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Provider Business Mailing Address
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Address Line | 6971 BUSINESS PARK BLVD N
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City | JACKSONVILLE
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State | FL
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Zip | 32256-2777
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Country | US
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Telephone | 904-880-9900
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Fax | 904-880-3241
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS PRACHI B RATHI
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Credential | MHA, OTR/L, LMT, CAP
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Telephone | 904-880-9900
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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 | 1313910
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License Number State | FL
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