Healthcare Provider Details

I. General information

NPI: 1841214103
Provider Name (Legal Business Name): PRIME PHARMACEUTICALS AND COMPOUNDING PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5505 PEACHTREE DUNWOODY RD NE SUITE G-95
ATLANTA GA
30342
US

IV. Provider business mailing address

5505 PEACHTREE DUNWOODY RD STE G95
ATLANTA GA
30342-1758
US

V. Phone/Fax

Practice location:
  • Phone: 404-250-9656
  • Fax: 404-250-9226
Mailing address:
  • Phone: 404-250-9656
  • Fax: 404-250-9226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. AREZOO AKHAVAN
Title or Position: NEW OWNER/PIC
Credential: RPH
Phone: 404-642-1818