Provider Demographics
NPI:1508537044
Name:PRIME HEALTH EXPRESS PHARMACEUTICAL SERVICES LLC
Entity Type:Organization
Organization Name:PRIME HEALTH EXPRESS PHARMACEUTICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:AKOSUA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADU ADDAI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:214-562-2696
Mailing Address - Street 1:1701 FM 1960 RD W STE L
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-3213
Mailing Address - Country:US
Mailing Address - Phone:214-562-2696
Mailing Address - Fax:214-562-2696
Practice Address - Street 1:1701 FM 1960 RD W STE L
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-3213
Practice Address - Country:US
Practice Address - Phone:214-562-2696
Practice Address - Fax:214-562-2696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy