Provider Demographics
NPI:1285045302
Name:PRIMROSE PHARMACY LLC
Entity Type:Organization
Organization Name:PRIMROSE PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP PHARMACY OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGOT
Authorized Official - Middle Name:
Authorized Official - Last Name:LELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-203-8576
Mailing Address - Street 1:4733 WEST ATLANTIC AVENUE
Mailing Address - Street 2:SUITE C 5
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445
Mailing Address - Country:US
Mailing Address - Phone:561-529-4935
Mailing Address - Fax:
Practice Address - Street 1:4733 WEST ATLANTIC AVENUE
Practice Address - Street 2:SUITE C 5
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445
Practice Address - Country:US
Practice Address - Phone:561-529-4935
Practice Address - Fax:561-404-4056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-12
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy