Prime Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH24868 Issued in FL

Legal business name

PRIME PHARMACY, LLC

Practice address

7685 103Rd St Ste 4
Jacksonville, FL 32210

Phone

(904) 813-7634

Fax

(904) 551-6555

NPI assigned

Apr 12, 2010

Organization subpart

No

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

Authorized official

Name

Sheraz Mirza

Title

Coo

Phone

(904) 551-6555

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 2

• Prime Pharmacy Doing business as
• Prime Pharmacy LLC Doing business as

Locations

Practitioners 1

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

• Rajendra P Warde, RPH

  • Pharmacist
  • Jacksonville, FL
  • NPI 1346572567
  NPD (past)

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

{
    "created_epoch": "1271030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547078400000",
    "number": "1962728360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7685 103RD ST STE 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322109325",
            "telephone_number": "904-813-7634",
            "fax_number": "904-551-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7685 103RD ST STE 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32210",
            "telephone_number": "904-813-7634",
            "fax_number": "904-551-6555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3604 University Blvd S",
            "address_2": "suite 102",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322164241",
            "country_code": "US",
            "telephone_number": "904-813-7634",
            "fax_number": "904-551-6555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIME PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-12",
        "last_updated": "2019-01-10",
        "status": "A",
        "authorized_official_last_name": "MIRZA",
        "authorized_official_first_name": "SHERAZ",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "904-551-6555"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH24868",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2126711",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002961800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prime Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prime Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Alexandra Maria Prince, RD, RDN, LD, LD/N
• Arielle Prince, PT

• Community/Retail Pharmacy in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; 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.