Provider Demographics
NPI:1114788544
Name:PRIMEMED PHARMACY, LLC
Entity Type:Organization
Organization Name:PRIMEMED PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-735-2002
Mailing Address - Street 1:1628 CRABB RIVER RD STE B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-5890
Mailing Address - Country:US
Mailing Address - Phone:832-735-2002
Mailing Address - Fax:832-735-2009
Practice Address - Street 1:1628 CRABB RIVER RD STE B
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-5890
Practice Address - Country:US
Practice Address - Phone:832-735-2002
Practice Address - Fax:832-735-2009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy