Provider Demographics
NPI:1588330310
Name:PRIORITY MEDICAL DIRECT INC
Entity type:Organization
Organization Name:PRIORITY MEDICAL DIRECT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TED
Authorized Official - Middle Name:R
Authorized Official - Last Name:ALBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-353-9881
Mailing Address - Street 1:2836 SE FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-5738
Mailing Address - Country:US
Mailing Address - Phone:866-583-1979
Mailing Address - Fax:800-517-1205
Practice Address - Street 1:2836 SE FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-5738
Practice Address - Country:US
Practice Address - Phone:866-583-1979
Practice Address - Fax:800-517-1205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-20
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies