| NPI | 1053096354 |
|---|---|
| Doing Business As | PRODIGY RX |
| Entity Type | Organization |
| Authorized Contact | PAUL NORKETT Chief Operating Officer 972-800-7674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2023-06-15 |
| Last Update Date | 2023-06-15 |