| Organization Name: | PRODIGY MEDICAL & HOSPITAL SUPPLIES, INC. |
| NPI Number: | 1770601999 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EKAETE G. OBONG (BUSSINESS MANAGER) |
| Mailing Address: | 430 West 14th Street (lincoln Highway) Chicago Heights |
| State: | IL US |
| Postal Code: | 604112663 |
| Phone Number: | 7087471900 |
| Fax Number: | 7087478700 |
| NPI Enumeration Date: | 03/26/2007 |
| NPI Last Update Date: | 02/12/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | =========001 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |