| NPI | 1295527463 |
|---|---|
| Doing Business As | PRODIGY SPECIALTY PHARMACY |
| Entity Type | Organization |
| Authorized Contact | KELLY PHAM Owner 909-362-0315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy |
| Enumeration Date | 2025-05-21 |
| Last Update Date | 2025-05-21 |