MEDICARE: HIGHRISE CASINO RX

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	13722	NV

General Provider Information

NPI Number	:	1629002894
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGHRISE CASINO RX

Provider Business Mailing Address
First Line	:	7700 LAS VEGAS BLVD S
Second Line	:	SUITE 8
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1757
Country	:	US
Telephone Number	:	702-364-0711
Fax Number	:	702-365-0711

Provider Business Practice Location Address
First Line	:	7700 LAS VEGAS BLVD S
Second Line	:	SUITE 8
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1757
Country	:	US
Telephone Number	:	702-364-0711
Fax Number	:	702-365-0711

Authorized Official
Title or Position	:	PHARMACY MANAGER
Name	:	MR. HANK MILLER
Credential	:
Telephone Number	:	702-364-0711

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	08/22/2020

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Directions to “HIGHRISE CASINO RX ” Practice Location

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