NPIMap

Organization Active NPI

Ccde, LLC

  • Compounding Pharmacy
  • Pahrump, NV
National Provider Identifier
1346892403
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Compounding PharmacyTaxonomy code 3336C0004X
Legal business name
CCDE, LLC
Doing business as
Pahrump Wellness Pharmacy and Nutrition Center
Practice address
2780 Homestead Rd
Pahrump, NV 89048-5399
Phone
(702) 960-8640
NPI assigned
Jul 9, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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

Authorized official

Name
Justin Daine Curnutt, PHARMDNPI 1316759368
Title
Owner
Phone
(702) 960-8640

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
Compounding Pharmacy 3336C0004X Primary

Addresses

Primary practice location

2780 Homestead Rd
Pahrump, NV 89048-5399

Mailing address

PO Box 6380
Pahrump, NV 89041-6380
Phone (702) 960-8640

Other names 1

  • Pahrump Wellness Pharmacy and Nutrition Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL pahrumpwellnesscenter.com Direct

National Provider Directory

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": "1562630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562630400000",
    "number": "1346892403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6380",
            "city": "PAHRUMP",
            "state": "NV",
            "postal_code": "890416380",
            "telephone_number": "702-960-8640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 HOMESTEAD RD",
            "city": "PAHRUMP",
            "state": "NV",
            "postal_code": "890485399",
            "telephone_number": "702-960-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCDE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-09",
        "last_updated": "2019-07-09",
        "status": "A",
        "authorized_official_last_name": "CURNUTT",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "DAINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-960-8640",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "pahrumpwellnesscenter.com",
            "affiliation": "N",
            "endpointDescription": "OTHER",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "pahrumpwc@gmail.com",
            "address_1": "2780 Homestead Rd",
            "city": "Pahrump",
            "state": "NV",
            "country_code": "US",
            "postal_code": "890485399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Pahrump Wellness Pharmacy and Nutrition Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pahrump, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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.