# PRIME PLUS PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Prime Plus Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316481898
- **Authorized official:** AMRO ATASSI RPH (OWNER, PIC, AO)
- **Authorized official phone:** (708) 741-7501

## Contact information

- **Practice address:** 2955 W 95TH ST, EVERGREEN PARK, IL 60805-2409
- **Practice address phone:** (708) 741-7501
- **Practice address fax:** (708) 907-5360
- **Mailing address:** 2955 W 95TH ST, EVERGREEN PARK, IL 60805-2409
- **Mailing address phone:** (708) 741-7501
- **Mailing address fax:** (708) 907-5360

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 054020162 | IL | Yes |

## Other

- **Enumeration date:** 12/18/2016
- **Last updated:** 10/29/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2166885 | PK | — |