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NPI Code Detail

MEDICARE: MR. DIMITRIS EFSTATHIOU PHARMD

MEDICARE: MR. DIMITRIS EFSTATHIOU PHARMD
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
1183500000XPharmacist17277NV

General Provider Information

NPI Number : 1962771121
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DIMITRIS EFSTATHIOU PHARMD
Provider Business Mailing Address
First Line : 3000 HIGH VIEW DR APT 412
Second Line :
City : HENDERSON
State : NV
Zip : 89014-3700
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2280 N LAS VEGAS BLVD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-5803
Country : US
Telephone Number : 702-649-1415
Fax Number : 702-649-1447
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2011
Last Update Date : 12/17/2011

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