{"npi":"1356790364","type":"NPI-2","status":"active","name":{"display":"Prime Therapeutics Pharmacy LLC","other":[],"organization_name":"PRIME THERAPEUTICS PHARMACY LLC","authorised_official":"Phi Tran"},"specialty":{"primary_taxonomy":"3336M0002X","primary_taxonomy_description":"Mail Order Pharmacy","slug":"mail-order-pharmacy","schema_org_specialty":null,"all":[{"code":"333600000X","description":"Pharmacy","primary":false,"state":null,"license":null},{"code":"3336S0011X","description":"Specialty Pharmacy","primary":false,"state":"UT","license":"10303032-1704"},{"code":"3336M0002X","description":"Mail Order Pharmacy","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"2256 S 3600 W STE A","city":"WEST VALLEY CITY","state":"UT","postal_code":"841191124","country_code":"US","phone":"8665542673","fax":"8663642673"},{"purpose":"MAILING","street_1":"2256 S 3600 W STE A","city":"WEST VALLEY CITY","state":"UT","postal_code":"841191124","country_code":"US","phone":"8665542673","fax":"8663642673"}],"license":null,"identifiers":[{"type_code":"01","label":"Other","value":"2162441","state":null,"issuer":"PK"},{"type_code":"01","label":"Other","value":"4613560","state":null,"issuer":"NABP"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20200519003140","type_code":"30-A5","type_desc":"DME SUPPLIER - PHARMACY","state":"UT","pac_id":"5294930640"}]},"enumeration_date":"2016-06-09","last_updated":"2024-09-16","_meta":{"source":"NPPES","snapshot_date":"2024-09-16","doc_url":"https://findmynpi.com/api"}}