Active NPI
Star Grace Rosario
- Pharmacist
- Henderson, NV
National Provider Identifier
1215537006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16303
- Practice address
- 10616 S Eastern Ave
Henderson, NV 89052-2926 - Phone
- (702) 614-8674
- Fax
- (702) 614-8674
- NPI assigned
- Oct 29, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 16303 | NV | Primary |
Addresses
Primary practice location
10616 S Eastern Ave
Henderson, NV 89052-2926
Mailing address
10616 S Eastern Ave
Henderson, NV 89052-2926
Phone (702) 614-8674
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16303 | NV | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smith'S Food & Drug Centers Inc | Past | Accepting new patients | |
| Smiths Food & Drug Centers Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Retail Pharmacy
- Henderson, NV
- NPI 1881585248
-
- Community/Retail Pharmacy
- Henderson, NV
- NPI 1740205368
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603929600000",
"number": "1215537006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10616 S EASTERN AVE",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890522926",
"telephone_number": "702-614-8674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10616 S EASTERN AVE",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890522926",
"telephone_number": "702-614-8674",
"fax_number": "702-614-8674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSARIO",
"first_name": "STAR",
"middle_name": "GRACE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-29",
"last_updated": "2020-10-29",
"certification_date": "2020-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "16303",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Oct 29, 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.