Organization Active NPI

Well Care Pharmacy I, LLC Series a

  • Community/Retail Pharmacy
  • Henderson, NV
National Provider Identifier
1770047391
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
WELL CARE PHARMACY I, LLC SERIES A
Practice address
80 N Pecos Rd
Henderson, NV 89074-3300
Phone
(702) 912-1400
NPI assigned
Jan 28, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Authorized official

Name
Vanessa Roberts
Title
General Manager
Phone
(702) 410-7801

Specialties & licenses 2

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

Addresses

Primary practice location

80 N Pecos Rd
Henderson, NV 89074-3300

Mailing address

3312 W Charleston Blvd
Las Vegas, NV 89102-1829
Phone (702) 410-7825

National Provider Directory

National Provider Directory
Tax ID family
Medtrans Behavioral Nevada Casal PLLC2 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.

Locations

80 N Pecos Rd
Henderson, NV 89074
Phone (702) 912-1400

NPI Registry JSON

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

{
    "created_epoch": "1548633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1770047391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3312 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021829",
            "telephone_number": "702-410-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 N PECOS RD",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890743300",
            "telephone_number": "702-912-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL CARE PHARMACY I, LLC SERIES A",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-28",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "702-410-7801"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.