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NPI Code Detail

MEDICARE: MARK SUNTAY PHARM.D

MEDICARE: MARK SUNTAY 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
1183500000XPharmacist18305NV

General Provider Information

NPI Number : 1558619569
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK SUNTAY PHARM.D
Provider Business Mailing Address
First Line : 8975 W WARM SPRINGS RD APT 2027
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-2895
Country : US
Telephone Number : 513-675-8550
Fax Number :
Provider Business Practice Location Address
First Line : 4875 S FORT APACHE RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-7944
Country : US
Telephone Number : 702-873-5165
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2012
Last Update Date : 08/22/2012

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Directions to “ MARK SUNTAY PHARM.D” Practice Location

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