Prime Pharmacy Services Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PHY48954 Issued in CA

Legal business name

PRIME PHARMACY SERVICES INC

Doing business as

Prime Pharmacy Services Inc

Practice address

4211 Avalon Blvd
Ste 2
Los Angeles, CA 90011-5622

Phone

(323) 432-5183

Fax

(323) 232-9414

NPI assigned

Apr 22, 2008

Last updated

Aug 11, 2008By 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

Russell Smith

Title

Cfo

Phone

(805) 529-1195

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• PRIME PHARMACY SERVICES INC Doing business as

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218412800000",
    "number": "1871767749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 WILSHIRE BLVD",
            "address_2": "STE 222",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 AVALON BLVD",
            "address_2": "STE 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900115622",
            "telephone_number": "323-432-5183",
            "fax_number": "323-232-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME PHARMACY SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-08-11",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "805-529-1195"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "PHY48954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5630086",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRIME PHARMACY SERVICES INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Long Term Care Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2008; 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.