MEDICARE: JORDAN NACOV

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	39028	CA
2	183500000X	Pharmacist	11883	NV
3	183500000X	Pharmacist	36178	NY

General Provider Information

NPI Number	:	1548666548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN NACOV

Provider Business Mailing Address
First Line	:	9080 LAWTON PINE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129
Country	:	US
Telephone Number	:	702-821-6926
Fax Number	:

Provider Business Practice Location Address
First Line	:	9080 LAWTON PINE DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7044
Country	:	US
Telephone Number	:	702-821-6926
Fax Number	:

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

Provider Enumeration Date	:	11/18/2014
Last Update Date	:	11/18/2014

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Directions to “ JORDAN NACOV ” Practice Location

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