Healthcare Provider Details

I. General information

NPI: 1003736885
Provider Name (Legal Business Name): MARIGOLD VIOLAGO ARCIGA RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 E CHARLESTON BLVD STE B130
LAS VEGAS NV
89104-6681
US

IV. Provider business mailing address

4000 E CHARLESTON BLVD STE B130
LAS VEGAS NV
89104-6681
US

V. Phone/Fax

Practice location:
  • Phone: 702-968-4038
  • Fax:
Mailing address:
  • Phone: 702-968-4038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number19215
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: