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Organization

PRIME PHARMACY SERVICES INC

Active
Other names
PRIME PHARMACY SERVICES INC
Organization subpart
No

Provider details

NPI number
Authorized official
RUSSELL SMITH (CFO)
(805) 529-1195
Entity
Organization

Contact information

Practice address
4211 AVALON BLVD, STE 2, LOS ANGELES, CA 90011-5622
(323) 432-5183
(323) 232-9414
Mailing address
3010 WILSHIRE BLVD, STE 222, LOS ANGELES, CA 90010-1146

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
3336L0003X
Long Term Care Pharmacy
Primary
PHY48954
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5630086
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
04/22/2008
Last updated
08/11/2008
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