| NPI | 1487978136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN TRUITT Senior VP 702-564-2079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy (Licence: NV PH02596) |
| Additional Taxonomies | 3336S0011X Pharmacy Specialty Pharmacy |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| 333600000X Pharmacy | |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2010-05-06 |