Organization
PRIME SPECIALTY PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIGNESH MANDAVIA (PHARMACIST)
(301) 204-3819
Entity
Organization
Contact information
Practice address
10215 MCINTYRE RIDGE RD, SUITE 101, PINEVILLE, NC 28134
(301) 204-3819
Mailing address
9622 PENSIVE LN, WAXHAW, NC 28173-3800
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
01/12/2023
Last updated
01/12/2023
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