Prime RX Pharmacy, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE009963 Issued in GA

Legal business name

PRIME RX PHARMACY, INC

Practice address

1500 Mount Zion Rd
Suite 104
Morrow, GA 30260-4155

Phone

(770) 968-3444

Fax

(770) 968-3666

NPI assigned

Oct 3, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Johnson Sorti Besong

Title

Owner

Phone

(404) 358-0620

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380758400000",
    "number": "1164859245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 MOUNT ZION RD",
            "address_2": "SUITE 104",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302604155",
            "telephone_number": "770-968-3444",
            "fax_number": "770-968-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 MOUNT ZION RD",
            "address_2": "SUITE 104",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302604155",
            "telephone_number": "770-968-3444",
            "fax_number": "770-968-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME RX PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-03",
        "last_updated": "2013-10-03",
        "status": "A",
        "authorized_official_last_name": "BESONG",
        "authorized_official_first_name": "JOHNSON",
        "authorized_official_middle_name": "SORTI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-358-0620",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Morrow, GA
• Providers in Morrow, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.