Provider Demographics
NPI:1225745508
Name:PRIME RX WEST COVINA INC
Entity Type:Organization
Organization Name:PRIME RX WEST COVINA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YING
Authorized Official - Middle Name:ANNIE
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:626-667-7108
Mailing Address - Street 1:18397 COLIMA RD
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-2749
Mailing Address - Country:US
Mailing Address - Phone:626-667-7108
Mailing Address - Fax:626-667-7193
Practice Address - Street 1:1523 E AMAR RD
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792-1619
Practice Address - Country:US
Practice Address - Phone:626-667-7108
Practice Address - Fax:626-667-7193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-04
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy