Provider Demographics
NPI:1922383694
Name:PRIME RX PHARMACY LLC
Entity Type:Organization
Organization Name:PRIME RX PHARMACY LLC
Other - Org Name:PRIME RX INFUSION PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INFUSION PHARMACY MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LUCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWDEN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:727-755-0990
Mailing Address - Street 1:10720 PARK BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-5461
Mailing Address - Country:US
Mailing Address - Phone:727-755-0990
Mailing Address - Fax:727-755-0985
Practice Address - Street 1:10720 PARK BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-5461
Practice Address - Country:US
Practice Address - Phone:727-755-0990
Practice Address - Fax:727-755-0985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-13
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy