Provider Demographics
NPI:1861927923
Name:NATIONWIDE PRIME MEDICAL SUPPLIES, LLC
Entity type:Organization
Organization Name:NATIONWIDE PRIME MEDICAL SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ARRABELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-861-8566
Mailing Address - Street 1:2575 PIO PICO DR
Mailing Address - Street 2:SUITE100
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1561
Mailing Address - Country:US
Mailing Address - Phone:760-994-0336
Mailing Address - Fax:760-994-0341
Practice Address - Street 1:2575 PIO PICO DR
Practice Address - Street 2:SUITE100
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1561
Practice Address - Country:US
Practice Address - Phone:760-994-0336
Practice Address - Fax:760-994-0341
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONWIDE PRIME MEDICAL SUPPLIES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-26
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies