PRX Pharmacorp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PRX PHARMACORP

Doing business as

Elevate Pharmacy

Practice address

8631 W 3Rd St Ste 320E
Los Angeles, CA 90048-5901

Phone

(310) 657-4090

Fax

(310) 657-4790

NPI assigned

Jun 17, 2009

Organization subpart

No

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

Authorized official

Name

Payam ShabbouiNPI 1215525720

Title

President/Ceo/Pic

Phone

(310) 657-4090

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• ELEVATE PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Payam Shabboui, PHARMD

  • Pharmacist
  • Beverly Hills, CA
  • NPI 1215525720
  NPD Authorized official

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1215164223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8631 W 3RD ST STE 320E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485901",
            "telephone_number": "310-657-4090",
            "fax_number": "310-657-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8631 W 3RD ST STE 320E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485901",
            "telephone_number": "310-657-4090",
            "fax_number": "310-657-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRX PHARMACORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-17",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "SHABBOUI",
        "authorized_official_first_name": "PAYAM",
        "authorized_official_title_or_position": "PRESIDENT/CEO/PIC",
        "authorized_official_telephone_number": "310-657-4090"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5634729",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "PHY59257",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELEVATE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madison Pruitt
• Nylicia Lacy Pruitt
• Oronica Pruitt
• Janessa Martinez Prum, BS, SLP-A
• Crystle Prung, PH.D.
• Yehudah Pryce, DSW, LCSW
• Jerry Judd Pryde Jr., MD, MPH
• Jennifer Monzell Pryer
• Arthur Edward Pryor Jr., MD
• Keli Nicole Pryor

• Community/Retail Pharmacy in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.