NPIMap

Organization Active NPI

Prime Plus Pharmacy LLC

  • Community/Retail Pharmacy
  • Evergreen Park, IL
National Provider Identifier
1316481898
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054020162 Issued in IL
Legal business name
PRIME PLUS PHARMACY LLC
Doing business as
Prime Plus Pharmacy
Practice address
2955 W 95TH St
Evergreen Park, IL 60805-2409
Phone
(708) 741-7501
Fax
(708) 907-5360
NPI assigned
Dec 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Authorized official

Name
Amro Atassi, RPHNPI 1861931792
Title
Owner, Pic, Ao
Phone
(708) 741-7501

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 054020162 IL Primary

Addresses

Primary practice location

2955 W 95TH St
Evergreen Park, IL 60805-2409

Mailing address

2955 W 95TH St
Evergreen Park, IL 60805-2409
Phone (708) 741-7501

Other identifiers 1

IdentifierTypeStateIssuer
2166885OtherPK

Other names 1

  • Prime Plus Pharmacy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1482019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603929600000",
    "number": "1316481898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052409",
            "telephone_number": "708-741-7501",
            "fax_number": "708-907-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052409",
            "telephone_number": "708-741-7501",
            "fax_number": "708-907-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME PLUS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-18",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A",
        "authorized_official_last_name": "ATASSI",
        "authorized_official_first_name": "AMRO",
        "authorized_official_title_or_position": "OWNER, PIC, AO",
        "authorized_official_telephone_number": "708-741-7501",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054020162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2166885",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prime Plus Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evergreen Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.