Provider Demographics
NPI:1124352273
Name:PRIME HEALTH MEDICAL, INC.
Entity type:Organization
Organization Name:PRIME HEALTH MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-893-8333
Mailing Address - Street 1:423 CHEROKEE DR
Mailing Address - Street 2:
Mailing Address - City:BROWNS MILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:08015-6443
Mailing Address - Country:US
Mailing Address - Phone:609-893-8333
Mailing Address - Fax:609-893-7251
Practice Address - Street 1:423 CHEROKEE DR
Practice Address - Street 2:
Practice Address - City:BROWNS MILLS
Practice Address - State:NJ
Practice Address - Zip Code:08015-6443
Practice Address - Country:US
Practice Address - Phone:609-893-8333
Practice Address - Fax:609-893-7251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ20090306125403094343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)