Healthcare Provider Details

I. General information

NPI: 1720856107
Provider Name (Legal Business Name): PRIME CARE DRUG & SURGICALS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2023
Last Update Date: 12/15/2023
Certification Date: 12/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2066 FLATBUSH AVE
BROOKLYN NY
11234-4314
US

IV. Provider business mailing address

2066 FLATBUSH AVE
BROOKLYN NY
11234-4314
US

V. Phone/Fax

Practice location:
  • Phone: 718-513-6644
  • Fax: 718-513-6449
Mailing address:
  • Phone: 718-513-6644
  • Fax: 718-513-6449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ARTHUR J. BYRD
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 718-748-7447