Active NPI
Anonglack Douangmala
- Pharmacist
- Henderson, NV
National Provider Identifier
1841025111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 24310
- Practice address
- 601 S Green Valley Pkwy
Henderson, NV 89052-0404 - Phone
- (702) 896-2956
- NPI assigned
- Sep 5, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 24310 | NV | Primary |
Addresses
Primary practice location
601 S Green Valley Pkwy
Henderson, NV 89052-0404
Mailing address
2305 W Horizon Ridge Pkwy Apt 3823
Henderson, NV 89052-5770
Phone (479) 789-0268
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24310 | NV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725494400000",
"number": "1841025111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2305 W HORIZON RIDGE PKWY APT 3823",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890525770",
"telephone_number": "479-789-0268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 S GREEN VALLEY PKWY",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890520404",
"telephone_number": "702-896-2956"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUANGMALA",
"first_name": "ANONGLACK",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-05",
"last_updated": "2024-09-05",
"certification_date": "2024-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "24310",
"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 Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.