MEDICARE: PRIME HEALTH RX INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	042061	OTHER	NY	LICENSE

General Provider Information

NPI Number	:	1306704192
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME HEALTH RX INC

Provider Business Mailing Address
First Line	:	810 E 147TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10455-4909
Country	:	US
Telephone Number	:	917-596-1155
Fax Number	:

Provider Business Practice Location Address
First Line	:	810 E 147TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10455-4909
Country	:	US
Telephone Number	:	917-596-1155
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GENESIS CASTELLANOS
Credential	:
Telephone Number	:	347-364-4336

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/13/2026

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Directions to “PRIME HEALTH RX INC ” Practice Location

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