Healthcare Provider Details

I. General information

NPI: 1396375457
Provider Name (Legal Business Name): ANDREW CARAPUCCI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2020
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 MOUNTAIN CITY HWY
ELKO NV
89801-2411
US

IV. Provider business mailing address

1740 MOUNTAIN CITY HWY
ELKO NV
89801-2411
US

V. Phone/Fax

Practice location:
  • Phone: 775-777-1337
  • Fax: 775-777-1343
Mailing address:
  • Phone: 775-777-1337
  • Fax: 775-777-1343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number20228
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: