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General NPI Number Information
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NPI Number | 1326947169
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Entity Type | Organization
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Legal Business Name | PRIMEMED LLC
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Dates
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Enumeration Date | 11/05/2026
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Last Update Date | 11/05/2026
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Provider Practice Location Address
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Address Line | 87 UNION ST APT 109E
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City | NEW HAVEN
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State | CT
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Zip | 06511-5873
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Country | US
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Telephone | 521-222-8940
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Fax |
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Provider Business Mailing Address
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Address Line | 87 UNION ST APT 109E
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City | NEW HAVEN
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State | CT
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Zip | 06511-5873
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Country | US
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Telephone | 521-222-8940
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MARYAM TARIQ
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Credential |
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Telephone | 551-222-8940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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