Flying Diamond Pharmacy LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PH02114 Issued in NV

Legal business name

FLYING DIAMOND PHARMACY LLC

Doing business as

Flying Diamond Pharmacy

Practice address

6140 Mae Anne Ave Ste 1B
Reno, NV 89523-4707

Phone

(775) 787-1144

Fax

(775) 787-1143

NPI assigned

May 24, 2006

Last updated

May 12, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Tamara W AveraNPI 1235885534

Title

Office Manager

Phone

(775) 787-1144

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• FLYING DIAMOND PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Tax ID family

Flying Diamond Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Flying Diamond Pharmacy LLC

  dba Flying Diamond Pharmacy

  • Long Term Care Pharmacy
  • Reno, NV
  • NPI 1275587867
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tamara W Avera, PHARMACY TECHNICIAN

  • Pharmacy Technician
  • Reno, NV
  • NPI 1235885534
  NPD Authorized official

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747008000000",
    "number": "1174578124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5326",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895135326",
            "telephone_number": "775-787-1144",
            "fax_number": "775-787-1143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 MAE ANNE AVE STE 1B",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895234707",
            "telephone_number": "775-787-1144",
            "fax_number": "775-787-1143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLYING DIAMOND PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A",
        "authorized_official_last_name": "AVERA",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "775-787-1144",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NV",
            "license": "PH02114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2052136",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174578124",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275587867",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FLYING DIAMOND PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jordan Grace Floyd
• Robert Tarrant Floyd, MD
• Vernon Floyd Jr.
• Fluid Movement Specialty Clinic, LLC
• Flying 7 Corporation (Core Health & Wellness Center)
• Flying Diamond Pharmacy LLC (Flying Diamond Pharmacy)
• Ryan Fockler, MA
• Theresa Fogal
• Manase Foketi
• Danae Sheree Foley, APRN

• Long Term Care Pharmacy in Reno, NV
• Providers in Reno, NV by specialty
• Long Term Care Pharmacy in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.