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NPI Code Detail

MEDICARE: BY HIS STRIPES INC

MEDICARE: BY HIS STRIPES INC
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
13336C0003XCommunity/Retail PharmacyPHO2711NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12992661OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number : 1497042600
Entity Type Code : Organization
Provider Name (Legal Business Name) : BY HIS STRIPES INC
Provider Business Mailing Address
First Line : 2870 S MARYLAND PKWY
Second Line : SUITE #110
City : LAS VEGAS
State : NV
Zip : 89109-5031
Country : US
Telephone Number : 702-836-3670
Fax Number : 702-836-3390
Provider Business Practice Location Address
First Line : 2870 S MARYLAND PKWY STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-1548
Country : US
Telephone Number : 702-836-3670
Fax Number : 702-836-3390
Authorized Official
Title or Position : MANAGER
Name : RACHEL TUNRAREBI
Credential :
Telephone Number : 702-290-4613
Provider Enumeration Date : 07/08/2011
Last Update Date : 08/01/2011

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Directions to “BY HIS STRIPES INC ” Practice Location

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