Organization
HMVN LLC
Active
Other names
Prime Rx Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KAMAL PATEL (RX MANAGER / PHARMACIST)
(813) 443-4766
Entity
Organization
Contact information
Practice address
7230 US HIGHWAY 301 S, SUITE 1, RIVERVIEW, FL 33578-4387
(813) 443-7466
(813) 443-7468
Mailing address
7230 US HIGHWAY 301 S, SUITE 1, RIVERVIEW, FL 33578-4387
(813) 443-7466
(813) 443-7468
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH24312
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001888600
—
FL
01
—
001888601
MEDICAID DME
FL
01
—
1050210
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/23/2009
Last updated
02/09/2011
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