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1578055026
PETER PONS BAUTISTA
LAS VEGAS, NV
NPI
1578055026
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
3336I0012X Pharmacy, Institutional Pharmacy
(Licence: NV 19662)
Enumeration Date
2018-05-31
Last Update Date
2018-05-31
Business Address
PETER PONS BAUTISTA PharmD, MBA
620 SHADOW LN PHARMACY
LAS VEGAS, NV 89106-4194
Phone number: 702-388-8479
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Mailing Address
PETER PONS BAUTISTA PharmD, MBA
620 SHADOW LN PHARMACY DEPARTMENT - PB
LAS VEGAS, NV 89106-4194
Phone number: 702-388-8479
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