MEDICARE: VEGAS SPECIALTY PHARMACY LLC

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
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1457224628
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VEGAS SPECIALTY PHARMACY LLC

Provider Business Mailing Address
First Line	:	3159 N RAINBOW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-4578
Country	:	US
Telephone Number	:	702-996-4455
Fax Number	:	702-941-9556

Provider Business Practice Location Address
First Line	:	3159 N RAINBOW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-4578
Country	:	US
Telephone Number	:	702-996-4455
Fax Number	:	702-941-9556

Authorized Official
Title or Position	:	CEO
Name	:	HASHIM NAWAZ
Credential	:	RPH
Telephone Number	:	725-219-6878

Provider Enumeration Date	:	09/24/2025
Last Update Date	:	09/24/2025

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