Healthcare Provider Details

I. General information

NPI: 1912042201
Provider Name (Legal Business Name): FVS HOLDINGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 02/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3041 W HORIZON RIDGE PKWY STE 100
HENDERSON NV
89052-3948
US

IV. Provider business mailing address

1850 WHITNEY MESA DR STE 180
HENDERSON NV
89014-2091
US

V. Phone/Fax

Practice location:
  • Phone: 702-293-6900
  • Fax: 702-293-0095
Mailing address:
  • Phone: 702-564-2079
  • Fax: 702-948-6820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License NumberPH01713
License Number StateNV

VIII. Authorized Official

Name: AMANDA WILLIAMS
Title or Position: ADMINISTRATION ASSISTANT
Credential:
Phone: 702-564-2079