Nellis Care Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH02838 Issued in NV

Legal business name

NELLIS CARE PHARMACY INC

Doing business as

Nellis Care Pharmacy

Practice address

348 N Nellis Blvd
Las Vegas, NV 89110-0053

Phone

(702) 531-6523

Fax

(702) 531-6524

NPI assigned

Mar 13, 2012

Last updated

Jun 21, 2016By 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

Shahn Sherafat

Title

Manager/Owner

Phone

(702) 272-2874

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• NELLIS CARE PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466467200000",
    "number": "1316212194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 MOUNT HOPE ST",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890147853",
            "telephone_number": "702-531-6523",
            "fax_number": "702-531-6524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 N NELLIS BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891100053",
            "telephone_number": "702-531-6523",
            "fax_number": "702-531-6524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NELLIS CARE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-13",
        "last_updated": "2016-06-21",
        "status": "A",
        "authorized_official_last_name": "SHERAFAT",
        "authorized_official_first_name": "SHAHN",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "702-272-2874"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NV",
            "license": "PH02838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2134367",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316212194",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10052733",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NELLIS CARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Neiman Group, LLC
• Dominic Neiman, RBT
• Olivia Yvonne Neiswender
• Mae Suma Nekoba, MSN, AGACNP-BC, APRN
• Riondra Trenaye Nellems
• Nellis Chiropractic, Inc.
• Nellis Home Health
• Nellis Home Health
• Gabriella Marie Nellis, RBT
• Ajay K. Nellutla, M.D.

• Community/Retail Pharmacy in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Community/Retail Pharmacy in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; 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.