Healthcare Provider Details

I. General information

NPI: 1003725128
Provider Name (Legal Business Name): ROBERT SAWA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7975 BLUE DIAMOND RD
LAS VEGAS NV
89178-9298
US

IV. Provider business mailing address

5809 CASA BRANCA ST
LAS VEGAS NV
89148-5357
US

V. Phone/Fax

Practice location:
  • Phone: 702-614-4331
  • Fax:
Mailing address:
  • Phone: 702-720-7741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number25305
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: