Provider Demographics
NPI:1659697746
Name:PRIME PHARMACY, INC.
Entity Type:Organization
Organization Name:PRIME PHARMACY, INC.
Other - Org Name:LEX DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HONG
Authorized Official - Middle Name:B
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-282-2958
Mailing Address - Street 1:4115 159TH ST FL 3
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-2512
Mailing Address - Country:US
Mailing Address - Phone:917-282-1600
Mailing Address - Fax:
Practice Address - Street 1:1797 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-2830
Practice Address - Country:US
Practice Address - Phone:212-426-0402
Practice Address - Fax:212-426-0403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy