Provider Demographics
NPI:1154559771
Name:PRIORITY CARE
Entity type:Organization
Organization Name:PRIORITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:NYBAKKEN
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-BASIC
Authorized Official - Phone:661-945-0520
Mailing Address - Street 1:PO BOX 902431
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93590-2431
Mailing Address - Country:US
Mailing Address - Phone:661-945-0520
Mailing Address - Fax:661-948-8476
Practice Address - Street 1:41747 12TH ST W
Practice Address - Street 2:SUITE G
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-1420
Practice Address - Country:US
Practice Address - Phone:661-945-0520
Practice Address - Fax:661-948-8476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)