MEDICARE: AN LAI

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	23894	NV

General Provider Information

NPI Number	:	1609656842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AN LAI

Provider Business Mailing Address
First Line	:	9620 W RUSSELL RD APT 1031
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-4504
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4110 S MARYLAND PKWY STE 17-18
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-7557
Country	:	US
Telephone Number	:	702-462-6262
Fax Number	:

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

Provider Enumeration Date	:	10/04/2023
Last Update Date	:	10/04/2023

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Directions to “ AN LAI ” Practice Location

Language	Start Address	Practice Location

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