NPIMap

Organization Active NPI

Greenleaf Pharmacy LLC

Doing business as Greenbay Specialty Pharmacy

  • Community/Retail Pharmacy
  • Las Vegas, NV
National Provider Identifier
1285398099
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
GREENLEAF PHARMACY LLC
Doing business as
Greenbay Specialty Pharmacy
Practice address
3483 S Eastern Ave Ste 100
Las Vegas, NV 89169-3314
Phone
(725) 254-3210
Fax
(725) 254-3211
NPI assigned
Oct 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Authorized official

Name
Parag PatelNPI 1326794942
Title
President/Owner
Phone
(443) 616-7285

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

3483 S Eastern Ave Ste 100
Las Vegas, NV 89169-3314

Mailing address

3483 S Eastern Ave Ste 100
Las Vegas, NV 89169-3314
Phone (419) 408-8840

Other names 1

  • Greenbay Specialty Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220317001707 NV DME Supplier - Pharmacy 2264827864 Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory
Tax ID family
Greenleaf Pharmacy LLC2 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.

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": "1635292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1285398099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3483 S EASTERN AVE STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891693314",
            "telephone_number": "419-408-8840",
            "fax_number": "855-928-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3483 S EASTERN AVE STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891693314",
            "telephone_number": "725-254-3210",
            "fax_number": "725-254-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENLEAF PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "PARAG",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "443-616-7285"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenbay Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Greenbay Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.