Van K Pham, PHARM D.

Key facts

NPI

1255960720

Entity type

Individual (NPI type 1)

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X

License

19678 (NV)

Practice address

4700 W Ann Rd
N Las Vegas, NV 89031-3463

Phone

(702) 395-7510

NPI assigned

Apr 6, 2020

Sex

Female

Sole proprietor

No

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.

• Smith'S Food & Drug Centers Inc Community/Retail Pharmacy · Henderson, NV · NPI 1881585248
  NPD (past)
• Smiths Food & Drug Centers Inc Community/Retail Pharmacy · North Las Vegas, NV · NPI 1013932631
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 6, 2020.

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1255960720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3602 SOCKEYE LN",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890320539",
            "telephone_number": "702-358-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 W ANN RD",
            "city": "N LAS VEGAS",
            "state": "NV",
            "postal_code": "890313463",
            "telephone_number": "702-395-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "VAN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PHARM D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NV",
            "license": "19678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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