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NPI Code Detail

MEDICARE: PRIORITY MEDICAL, INC.

MEDICARE: PRIORITY MEDICAL, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1246Z00000XOther Specialist/Technologist
2335E00000XProsthetic/Orthotic Supplier
3332BC3200XCustomized Equipment (DME)HP0105800NJ

General Provider Information

NPI Number : 1891713764
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIORITY MEDICAL, INC.
Provider Business Mailing Address
First Line : 748 MORRIS TPKE STE 203
Second Line :
City : SHORT HILLS
State : NJ
Zip : 07078-2617
Country : US
Telephone Number : 973-376-5077
Fax Number : 973-376-2615
Provider Business Practice Location Address
First Line : 748 MORRIS TPKE STE 203
Second Line :
City : SHORT HILLS
State : NJ
Zip : 07078
Country : US
Telephone Number : 973-376-5077
Fax Number : 973-376-2615
Authorized Official
Title or Position : PRESIDENT
Name : RUSSELL HUIZING
Credential :
Telephone Number : 973-376-5077
Provider Enumeration Date : 07/18/2006
Last Update Date : 02/11/2020

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