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General NPI Number Information
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NPI Number | 1679167340
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Entity Type | Organization
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Legal Business Name | PRIME PHARMACY
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Dates
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Enumeration Date | 02/23/2021
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Last Update Date | 11/23/2021
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Provider Practice Location Address
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Address Line | 125 WASHINGTON AVE FL 2
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City | CARTERET
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State | NJ
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Zip | 07008-2635
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Country | US
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Telephone | 732-366-2656
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Fax | 732-352-0951
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Provider Business Mailing Address
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Address Line | 125 WASHINGTON AVE FL 2
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City | CARTERET
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State | NJ
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Zip | 07008-2635
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Country | US
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Telephone | 732-366-2656
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Fax | 732-352-0951
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Authorized Official
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Title or Position | OWNER
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Name | DAVE WATTS
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Credential | PHARM D
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Telephone | 732-239-9031
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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