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General NPI Number Information
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NPI Number | 1518422971
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Entity Type | Organization
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Legal Business Name | PRIME THERAPEUTIC CONSULTING & SERVICES, LLC
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Dates
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Enumeration Date | 02/09/2019
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Last Update Date | 10/27/2020
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Provider Practice Location Address
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Address Line | 120 W HICKORY ST
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City | LAKELAND
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State | FL
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Zip | 33815-4715
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Country | US
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Telephone | 863-608-7577
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Fax | 863-686-6732
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Provider Business Mailing Address
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Address Line | 120 W HICKORY ST
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City | LAKELAND
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State | FL
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Zip | 33815-4715
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Country | US
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Telephone | 863-608-7577
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Fax | 863-686-6732
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | DR. FRANTZ NERESTANT
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Credential | PHARMD
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Telephone | 863-608-7577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #4
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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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Taxonomy #5
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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