Prime Specialty Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

PRIME SPECIALTY PHARMACY

Practice address

10215 McIntyre Ridge Rd
Suite 101
Pineville, NC 28134

Phone

(301) 204-3819

NPI assigned

Jan 12, 2023

Last updated

Jan 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jignesh MandaviaNPI 1235437005

Title

Pharmacist

Phone

(301) 204-3819

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jignesh Mandavia

  • Pharmacist
  • Pineville, NC
  • NPI 1235437005
  NPD Authorized official
• Ankit J Patel, RPH

  • Pharmacist
  • Mooresville, NC
  • NPI 1013239441
  NPD

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

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673481600000",
    "number": "1316651482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9622 PENSIVE LN",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281733800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10215 MCINTYRE RIDGE RD",
            "address_2": "SUITE 101",
            "city": "PINEVILLE",
            "state": "NC",
            "postal_code": "28134",
            "telephone_number": "301-204-3819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME SPECIALTY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-05",
        "status": "A",
        "authorized_official_last_name": "MANDAVIA",
        "authorized_official_first_name": "JIGNESH",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "301-204-3819"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Crist Plano
• Courtney Powell, DPT
• Emily Powell, M.A, LPCA
• Pr1Me Movement
• Taylor Nicole Price, PA-C
• Daniel Promutico, DPT
• Carlton Jeffrey Rausch, NP
• Re-Hab-It Inc
• Rebecca N. Triplett, PLLC (Trident Smile Studio)
• Recovery Services of the Carolinas, LLC

• Pharmacy in Pineville, NC
• Providers in Pineville, NC by specialty
• Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.