NPIMap

Organization Active NPI

Prime Therapeutics LLC

  • Mail Order Pharmacy
  • Eagan, MN
National Provider Identifier
1669601878
Registry record updated Jul 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mail Order PharmacyTaxonomy code 3336M0002X
License
262623-3 Issued in MN
Legal business name
PRIME THERAPEUTICS LLC
Practice address
1305 Corporate Center Dr
Eagan, MN 55121-1204
Phone
(612) 444-4789
NPI assigned
Jul 9, 2009
Last updated
Jul 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2009

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

Authorized official

Name
Mr. Charles Roerick
Title
Cfo
Phone
(612) 777-4592

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mail Order Pharmacy 3336M0002X 262623-3 MN Primary

Addresses

Primary practice location

1305 Corporate Center Dr
Eagan, MN 55121-1204

Mailing address

1305 Corporate Center Dr
Eagan, MN 55121-1204
Phone (612) 444-4789

National Provider Directory

National Provider Directory
Tax ID family
Prime Therapeutics LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1305 Corporate Center Dr
Saint Paul, MN 55121
Phone (612) 444-4789

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1247097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247097600000",
    "number": "1669601878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 CORPORATE CENTER DR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211204",
            "telephone_number": "612-444-4789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 CORPORATE CENTER DR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211204",
            "telephone_number": "612-444-4789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME THERAPEUTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-09",
        "last_updated": "2009-07-09",
        "status": "A",
        "authorized_official_last_name": "ROERICK",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "612-777-4592",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "MN",
            "license": "262623-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2009; 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.