NPIMap

Organization Active NPI

Centerwell Pharmacy, Inc.

  • Pharmacy
  • Las Vegas, NV
National Provider Identifier
1508314246
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PH03608 Issued in NV
Legal business name
CENTERWELL PHARMACY, INC.
Practice address
1000 S Rainbow Blvd
Las Vegas, NV 89145-6231
Phone
(702) 854-7812
Fax
(702) 259-2404
NPI assigned
Sep 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Authorized official

Name
Sean Lysinger
Title
VP
Phone
(502) 580-2376

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PH03608 NV Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

1000 S Rainbow Blvd
Las Vegas, NV 89145-6231

Mailing address

1000 S Rainbow Blvd
Las Vegas, NV 89145-6231
Phone (702) 854-7812

Other identifiers 1

IdentifierTypeStateIssuer
2164075OtherPK

Other names 1

  • Humana Pharmacy, Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190822001159 NV Part B Supplier - Pharmacy 9739233743 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Las Vegas, NV; Pahrump, NV
O20200501001427 NV Part B Supplier - Mass Immunization (Roster Biller Only) 9739233743 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Las Vegas, NV; Pahrump, NV

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Humana Pharmacy- Homestead47 organizations share this tax ID, including this one

Other organizations with this tax ID 46

Organizations that report the same tax identification number in the National Provider Directory.

View all 46

Locations

1000 S Rainbow Blvd
Las Vegas, NV 89145
Phone (702) 259-0088

NPI Registry JSON

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771891200000",
    "number": "1508314246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 S RAINBOW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891456231",
            "telephone_number": "702-854-7812",
            "fax_number": "702-259-2404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S RAINBOW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891456231",
            "telephone_number": "702-854-7812",
            "fax_number": "702-259-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERWELL PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-12",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A",
        "authorized_official_last_name": "LYSINGER",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "502-580-2376"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NV",
            "license": "PH03608",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2164075",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Humana Pharmacy, Inc.",
            "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 Feb 24, 2026; 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.