Organization
PRIME DRUG INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMINE DETOMASIS (VP)
(401) 521-9660
Entity
Organization
Contact information
Practice address
613 CRANSTON ST, PROVIDENCE, RI 02907-2813
(401) 521-9660
(401) 861-1177
Mailing address
613 CRANSTON ST, PROVIDENCE, RI 02907-2813
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHA00075
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4101919
OTHER ID NUMBER
—
05
—
PD02331
—
RI
Enumeration date
01/08/2007
Last updated
05/30/2008
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