Procare Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH02774 Issued in NV

Legal business name

PROCARE PHARMACY LLC

Practice address

6870 S Rainbow Blvd
Suite 106
Las Vegas, NV 89118-2106

Phone

(702) 207-7777

Fax

(702) 207-0644

NPI assigned

Jan 20, 2012

Organization subpart

No

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

Authorized official

Name

Thai Vo

Title

Owner/President

Phone

(702) 426-6414

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Procare Pharmacy LLC Doing business as

Locations

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

{
    "created_epoch": "1327017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332979200000",
    "number": "1962773135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6870 S RAINBOW BLVD",
            "address_2": "SUITE 106",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891182106",
            "telephone_number": "702-207-7777",
            "fax_number": "702-207-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6870 S RAINBOW BLVD",
            "address_2": "SUITE 106",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891182106",
            "telephone_number": "702-207-7777",
            "fax_number": "702-207-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCARE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-20",
        "last_updated": "2012-03-29",
        "status": "A",
        "authorized_official_last_name": "VO",
        "authorized_official_first_name": "THAI",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "702-426-6414"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NV",
            "license": "PH02774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2992887",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Procare Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Andre Proctor
• Danielle Proctor
• Jennifer Amanda Proctor
• Karissa Nicole Proctor, RN

• 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 Mar 29, 2012; 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.