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General NPI Number Information
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NPI Number | 1447543384
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Entity Type | Organization
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Legal Business Name | PRIME ESSENTIALS LLC
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Dates
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Enumeration Date | 05/25/2011
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Last Update Date | 07/28/2014
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Provider Practice Location Address
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Address Line | 345 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10013
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Country | US
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Telephone | 212-941-7900
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Fax | 212-941-4720
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Provider Business Mailing Address
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Address Line | 345 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10013
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Country | US
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Telephone | 212-941-7900
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Fax | 212-941-4720
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Authorized Official
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Title or Position | PARTNER/OWNER
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Name | ARASH RAHMANI
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Credential |
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Telephone | 516-382-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 030587
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License Number State | NY
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