Nevada State Pharmacy - Las Vegas LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PH03815 Issued in NV

Legal business name

NEVADA STATE PHARMACY - LAS VEGAS LLC

Doing business as

Nevada State Pharmacy

Practice address

3022 W Post Rd
Las Vegas, NV 89118-3836

Phone

(702) 916-1600

Fax

(702) 916-1900

NPI assigned

Aug 28, 2017

Organization subpart

No

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

Authorized official

Name

John Martin

Title

Director

Phone

(702) 916-1600

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Nevada State Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1982121109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3022 W POST RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891183836",
            "telephone_number": "702-916-1600",
            "fax_number": "702-916-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3022 W POST RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891183836",
            "telephone_number": "702-916-1600",
            "fax_number": "702-916-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEVADA STATE PHARMACY - LAS VEGAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-28",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "702-916-1600"
    },
    "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": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NV",
            "license": "PH03815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2171424",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nevada State Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Long Term Care Pharmacy in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.