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General NPI Number Information
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NPI Number | 1891562211
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Entity Type | Organization
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Legal Business Name | PRIME QRX CORP
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Dates
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Enumeration Date | 12/06/2023
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 9716 ROCKAWAY BLVD
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City | OZONE PARK
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State | NY
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Zip | 11417
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Country | US
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Telephone | 718-848-2040
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Fax | 718-848-2026
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Provider Business Mailing Address
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Address Line | 9716 ROCKAWAY BLVD
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City | OZONE PARK
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State | NY
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Zip | 11417
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Country | US
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Telephone | 718-848-2040
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Fax | 718-848-2026
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Authorized Official
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Title or Position | PRESIDENT
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Name | PETER KOPACH
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Credential |
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Telephone | 718-848-2040
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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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