# PRIME RX PHARMACY, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164859245
- **Authorized official:** MR. JOHNSON SORTI BESONG (OWNER)
- **Authorized official phone:** (404) 358-0620

## Contact information

- **Practice address:** 1500 MOUNT ZION RD, SUITE 104, MORROW, GA 30260-4155
- **Practice address phone:** (770) 968-3444
- **Practice address fax:** (770) 968-3666
- **Mailing address:** 1500 MOUNT ZION RD, SUITE 104, MORROW, GA 30260-4155
- **Mailing address phone:** (770) 968-3444
- **Mailing address fax:** (770) 968-3666

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | PHRE009963 | GA | Yes |

## Other

- **Enumeration date:** 10/03/2013
- **Last updated:** 10/03/2013