Provider Demographics
NPI:1811630841
Name:ACCESS PRIME PHARMCY LLC
Entity Type:Organization
Organization Name:ACCESS PRIME PHARMCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE & OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:FROMMELT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:541-413-2860
Mailing Address - Street 1:PO BOX 812
Mailing Address - Street 2:
Mailing Address - City:BURNS
Mailing Address - State:OR
Mailing Address - Zip Code:97720-0812
Mailing Address - Country:US
Mailing Address - Phone:541-413-2860
Mailing Address - Fax:541-413-2960
Practice Address - Street 1:191 S BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:BURNS
Practice Address - State:OR
Practice Address - Zip Code:97720-2204
Practice Address - Country:US
Practice Address - Phone:541-413-2860
Practice Address - Fax:541-413-2960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy