Prosperity Prince William RX Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0201004275 Issued in VA

Legal business name

PROSPERITY PRINCE WILLIAM RX INC

Practice address

8644 Sudley Rd
Suite 120
Manassas, VA 20110-4417

Phone

(703) 334-5180

Fax

(703) 334-5184

NPI assigned

Feb 19, 2009

Organization subpart

No

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

Authorized official

Name

Frank Odeh, RPH

Title

President

Phone

(571) 730-1130

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Prosperity Pharmacy Manassas Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

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 1

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

• Vinod B Patel, PHARMD

  • Pharmacist
  • Manassas, VA
  • NPI 1619127982
  NPD (past)

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

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492992000000",
    "number": "1801035548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8644 SUDLEY RD",
            "address_2": "SUITE 120",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104417",
            "telephone_number": "703-334-5180",
            "fax_number": "703-334-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8644 SUDLEY RD",
            "address_2": "SUITE 120",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104417",
            "telephone_number": "703-334-5180",
            "fax_number": "703-334-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPERITY PRINCE WILLIAM RX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-19",
        "last_updated": "2017-04-24",
        "status": "A",
        "authorized_official_last_name": "ODEH",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "571-730-1130",
        "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": "VA",
            "license": "0201004275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801035548",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2118235",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prosperity Pharmacy Manassas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Manassas, VA
• Providers in Manassas, VA by specialty
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; 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.