| NPI | 1417192980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES COSTAS Statewide Pharmacy Director 702-486-6301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy Clinic Pharmacy (Licence: NV PH01180) |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2016-07-13 |