MEDICARE: PRIME, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	RX0200323	DC

General Provider Information

NPI Number	:	1669541777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME, INC

Provider Business Mailing Address
First Line	:	1647 BENNING RD NE
Second Line	:	STE 101
City	:	WASHINGTON
State	:	DC
Zip	:	20002-4569
Country	:	US
Telephone Number	:	202-399-7876
Fax Number	:	202-388-3157

Provider Business Practice Location Address
First Line	:	1647 BENNING RD NE
Second Line	:	STE 101
City	:	WASHINGTON
State	:	DC
Zip	:	20002-4569
Country	:	US
Telephone Number	:	202-399-7876
Fax Number	:	202-388-3157

Authorized Official
Title or Position	:	PHARMACY MANAGER
Name	:	MR. OMOLOLU ABIMBOLA FATUKASI
Credential	:	R. PH
Telephone Number	:	202-399-7876

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	02/14/2008

Similar Medicare Providers

1033100581 — DR. NORMAN W ALLEN MD
Practice Location Address:

1647 BENNING RD NE , STE 201
WASHINGTON, DC
20002-4569

Practice Phone: 202-399-5707
Practice Fax: 202-399-5708

1912982273 — DR. RICHARD B ASHBY M.D.
Practice Location Address:

1647 BENNING RD NE , SUITE 301/302
WASHINGTON, DC
20002-4569

Practice Phone: 202-398-2100
Practice Fax: 202-396-4778

1912959073 — ISMAIL M. KALOKOH MD MD
Practice Location Address:

1647 BENNING RD NE , SUITE 304
WASHINGTON, DC
20002-4569

Practice Phone: 202-397-2200
Practice Fax: 202-397-2688

1093748568 — KEESHA MARIE WILLIAMS-ELLIOTT M.D.
Practice Location Address:

1647 BENNING RD NE , SUITE 102
WASHINGTON, DC
20002-4569

Practice Phone: 202-396-8200
Practice Fax:

1750477600 — GREGORY BUTLER, MD, PC.
Practice Location Address:

1647 BENNING RD NE , SUITE 205
WASHINGTON, DC
20002-4569

Practice Phone: 202-397-2800
Practice Fax: 202-397-1304

1275621021 — FAMILY PRACTICES MEDICAL SERVICES, PC
Practice Location Address:

1647 BENNING RD NE , SUITE 301
WASHINGTON, DC
20002-4569

Practice Phone: 202-398-2100
Practice Fax:

Directions to “PRIME, INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.