NPIMap

Organization Active NPI

Wellness Pharmacy LLC

  • Community/Retail Pharmacy
  • Henderson, NV
National Provider Identifier
1134541691
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH03127 Issued in NV
Legal business name
WELLNESS PHARMACY LLC
Practice address
80 N Pecos Rd Ste I
Henderson, NV 89074-3379
Phone
(702) 912-1400
Fax
(702) 912-1401
NPI assigned
Jan 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Authorized official

Name
Thai Vo
Title
Manager
Phone
(702) 912-1400

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PH03127 NV Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

80 N Pecos Rd Ste I
Henderson, NV 89074-3379

Mailing address

80 N Pecos Rd Ste I
Henderson, NV 89074-3379
Phone (702) 912-1400

Other identifiers 2

IdentifierTypeStateIssuer
1134541691MedicaidNV
2144307OtherPK

Other names 1

  • Wellness Pharmacy LLC Doing business as

National Provider Directory

National Provider Directory

Locations

80 N Pecos Rd
Ste I
Henderson, NV 89074
Phone (702) 912-1400

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1389916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1134541691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 N PECOS RD STE I",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890743379",
            "telephone_number": "702-912-1400",
            "fax_number": "702-912-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 N PECOS RD STE I",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890743379",
            "telephone_number": "702-912-1400",
            "fax_number": "702-912-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-17",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "VO",
        "authorized_official_first_name": "THAI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "702-912-1400"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NV",
            "license": "PH03127",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134541691",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2144307",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellness Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wellness Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.