Organization
PRIME THERAPEUTICS PHARMACY LLC
Active
Other names
Magellan Rx Pharmacy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
PHI TRAN (PIC)
(855) 271-4810
Entity
Organization
Contact information
Practice address
2256 S 3600 W STE A, WEST VALLEY CITY, UT 84119-1124
(866) 554-2673
(866) 364-2673
Mailing address
2256 S 3600 W STE A, WEST VALLEY CITY, UT 84119-1124
(866) 554-2673
(866) 364-2673
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
10303032-1704
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2162441
PK
—
01
—
4613560
NABP
—
Enumeration date
06/09/2016
Last updated
09/16/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us