# PRIME PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MEDI MART PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205847860
- **Authorized official:** RAYMOND FANKELL RPH (OWNER/PHARMACIST)
- **Authorized official phone:** (740) 354-3291

## Contact information

- **Practice address:** 902 4TH ST, PORTSMOUTH, OH 45662-4314
- **Practice address phone:** (740) 354-3291
- **Practice address fax:** (740) 354-3292
- **Mailing address:** 902 4TH ST, PORTSMOUTH, OH 45662-4314
- **Mailing address phone:** (740) 354-3291
- **Mailing address fax:** (740) 354-3292

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | RTP.020589200-02 | OH | Yes |

## Other

- **Enumeration date:** 08/10/2006
- **Last updated:** 08/01/2014