Healthcare Provider Details

I. General information

NPI: 1316665474
Provider Name (Legal Business Name): CHRISTOPHER LOLONG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2022
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 N STEPHANIE ST
HENDERSON NV
89014-6612
US

IV. Provider business mailing address

4156 NOPAL SERRANO AVE
LAS VEGAS NV
89141-9114
US

V. Phone/Fax

Practice location:
  • Phone: 702-728-5105
  • Fax: 702-675-8843
Mailing address:
  • Phone: 702-493-4325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23047
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: