Provider Demographics
NPI:1699301093
Name:PRIORITYONE EMS AND MEDICAL SUPPLY, LLC
Entity type:Organization
Organization Name:PRIORITYONE EMS AND MEDICAL SUPPLY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:CLAUDE
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:978-230-9668
Mailing Address - Street 1:PO BOX 182
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01853-0182
Mailing Address - Country:US
Mailing Address - Phone:978-230-9668
Mailing Address - Fax:866-253-8848
Practice Address - Street 1:246 CRAWFORD ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-1634
Practice Address - Country:US
Practice Address - Phone:978-230-9668
Practice Address - Fax:866-253-8848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-17
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI17965OtherPROVIDER LICENSE RI
MAE0912184OtherPROVIDER LICENSE
NH33999EOtherPROVIDER LICENSE NH
FL560555OtherPROVIDER LICENSE FL