Healthcare Provider Details

I. General information

NPI: 1619891785
Provider Name (Legal Business Name): RHYAN LAGARDE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 09/13/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9695 S MARYLAND PKWY
LAS VEGAS NV
89123-5950
US

IV. Provider business mailing address

PO BOX 777304
HENDERSON NV
89077-7304
US

V. Phone/Fax

Practice location:
  • Phone: 702-896-1283
  • Fax: 702-896-4834
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21169
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: