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General NPI Number Information
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NPI Number | 1467632224
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Entity Type | Organization
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Legal Business Name | PRIME PHARMACY SERVICES, LLC
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Dates
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Enumeration Date | 11/09/2007
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 2427 PORTER LAKE DR STE 109A
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City | SARASOTA
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State | FL
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Zip | 34240-8853
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Country | US
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Telephone | 941-378-2607
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Fax | 941-378-2699
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Provider Business Mailing Address
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Address Line | 1861 BANKS RD STE A
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City | MARGATE
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State | FL
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Zip | 33063-7707
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Country | US
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Telephone | 954-977-7875
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Fax | 965-977-7871
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK ERBLAT
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Credential |
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Telephone | 941-378-9004
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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 | PH23013
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License Number State | FL
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