Provider Demographics
NPI:1598595118
Name:PRIME CARE DRUG & SURGICALS CORP.
Entity type:Organization
Organization Name:PRIME CARE DRUG & SURGICALS CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-513-6644
Mailing Address - Street 1:2066 FLATBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4314
Mailing Address - Country:US
Mailing Address - Phone:718-513-6644
Mailing Address - Fax:718-513-6449
Practice Address - Street 1:2066 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4314
Practice Address - Country:US
Practice Address - Phone:718-513-6644
Practice Address - Fax:718-513-6449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy