Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oxygen Equipment & Supplies |
332BX2000X | B1 | Oxygen supplier | |
Durable Medical Equipment & Medical Supplies |
332B00000X | 54 | Other Medical Supply Company | |
Parenteral & Enteral Nutrition |
332BP3500X | 87 | All Other Suppliers |
| NPI # | 1912473885 |
| LBN Legal business name | PRODIGY MEDICAL, LLC |
| Authorized official | MARK HALPIN - (CEO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 10/18/2018 |
| Last updated | 01/14/2026 - About 5 months ago |
| Identifiers | n/a |
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