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NPI Code Detail

MEDICARE: KERRI ANN SIU BALA PHARMD

MEDICARE: KERRI ANN SIU BALA PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist16094NV

General Provider Information

NPI Number : 1154621126
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERRI ANN SIU BALA PHARMD
Provider Business Mailing Address
First Line : 7405 S DURANGO DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-3605
Country : US
Telephone Number : 702-407-2524
Fax Number : 702-407-2516
Provider Business Practice Location Address
First Line : 7405 S DURANGO DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-3605
Country : US
Telephone Number : 702-407-2524
Fax Number : 702-407-2516
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2010
Last Update Date : 10/25/2010

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Directions to “ KERRI ANN SIU BALA PHARMD” Practice Location

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