Provider Demographics
NPI:1548367063
Name:PRISM MEDICAL PRODUCTS, L.L.C.
Entity type:Organization
Organization Name:PRISM MEDICAL PRODUCTS, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JON
Authorized Official - Last Name:CARTWRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-244-6421
Mailing Address - Street 1:PO BOX 476
Mailing Address - Street 2:
Mailing Address - City:ELKIN
Mailing Address - State:NC
Mailing Address - Zip Code:28621-0476
Mailing Address - Country:US
Mailing Address - Phone:888-244-6421
Mailing Address - Fax:800-975-6321
Practice Address - Street 1:112 CHURCH ST STE 101
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-3476
Practice Address - Country:US
Practice Address - Phone:888-244-6421
Practice Address - Fax:800-975-6321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-19
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX205277102Medicaid
VA1548367063Medicaid
LA2137671Medicaid
AL125216Medicaid
KY7100032310Medicaid
SCDM1293Medicaid
IN1548367063Medicaid
NC7704585Medicaid
AR181334716Medicaid
OK200243820AMedicaid
MS09376349Medicaid
NC5823260001Medicare NSC