Marilyn Medina

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

20608 Issued in NV

Practice address

4411 E Bonanza Rd
Las Vegas, NV 89110-3385

Phone

(702) 452-5652

NPI assigned

Nov 16, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nevada CVS Pharmacy LLC

  • Pharmacy
  • Las Vegas, NV
  • NPI 1528581865
  NPD (past)
• Nevada CVS Pharmacy LLC

  • Pharmacy
  • Las Vegas, NV
  • NPI 1548204894
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1043813850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5476 FUNKS GROVE LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891227764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 E BONANZA RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891103385",
            "telephone_number": "702-452-5652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "MARILYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-16",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NV",
            "license": "20608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Medina
• Laura Medina
• Leticia Medina
• Maria Medina
• Maria Medina
• Maritza Medina
• Mercedes Medina
• Michiela Medina
• Monica Medina
• Mylila Asuncion Medina

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.