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NPI Code Detail

MEDICARE: MRS. REYSHELLE MATANGUIHAN TUCKER RPH

MEDICARE:  MRS. REYSHELLE MATANGUIHAN TUCKER  RPH
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
1183500000XPharmacist18219NV

General Provider Information

NPI Number : 1558622944
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. REYSHELLE MATANGUIHAN TUCKER RPH
Provider Business Mailing Address
First Line : 6435 ALIANTE PKWY
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89084-3196
Country : US
Telephone Number : 702-657-6508
Fax Number :
Provider Business Practice Location Address
First Line : 6435 ALIANTE PKWY
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89084-3196
Country : US
Telephone Number : 702-657-6508
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2012
Last Update Date : 01/20/2023

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Directions to “ MRS. REYSHELLE MATANGUIHAN TUCKER RPH” Practice Location

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