MEDICARE: W R PHARMACIES INC

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PH01993	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2988941	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1801962907
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	W R PHARMACIES INC

Provider Business Mailing Address
First Line	:	7450 W CHEYENNE AVE STE 112
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7409
Country	:	US
Telephone Number	:	702-360-5310
Fax Number	:	702-360-4025

Provider Business Practice Location Address
First Line	:	7450 W CHEYENNE AVE STE 112
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7409
Country	:	US
Telephone Number	:	702-360-5310
Fax Number	:	702-360-4025

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOEL RAIMAN
Credential	:
Telephone Number	:	702-360-5310

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	03/11/2011

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Directions to “W R PHARMACIES INC ” Practice Location

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