Samuel Mersha Admasu
Individual provider Active NPI Pharmacist · Las Vegas, NV
NPI 1134496128 · NPPES record last updated Nov 19, 2011
Key facts
- NPI
- 1134496128
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 13711 (NV)
- Practice address
- 495 Fremont Street
Las Vegas, NV 89101 - Phone
- (702) 385-1284
- NPI assigned
- Nov 19, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13711 | NV | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13711 | NV | Yes |
Addresses
Primary practice location
495 Fremont Street
Las Vegas, NV 89101
Mailing address
7118 Puetollano Dr
North Las Vegas, NV 89084-2341
Phone (702) 553-6906
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.