MEDICARE: MR. CHRISTIAN CLARENCE AGYEI PHARM.D

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	183500000X	Pharmacist	RPH 59474	CA
2	183500000X	Pharmacist	45010	TX
3	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	16974	NV

General Provider Information

NPI Number	:	1518249408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTIAN CLARENCE AGYEI PHARM.D

Provider Business Mailing Address
First Line	:	6632 ARROW HILL ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-2082
Country	:	US
Telephone Number	:	702-430-9800
Fax Number	:	702-430-9800

Provider Business Practice Location Address
First Line	:	6632 ARROW HILL ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-2082
Country	:	US
Telephone Number	:	702-430-9800
Fax Number	:	702-430-9800

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2011
Last Update Date	:	09/15/2011

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