Healthcare Provider Details

I. General information

NPI: 1679391460
Provider Name (Legal Business Name): DISTRICT PHARMACY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1807 W CHARLESTON BLVD STE 110
LAS VEGAS NV
89102-2323
US

IV. Provider business mailing address

2505 ANTHEM VILLAGE DR STE E460
HENDERSON NV
89052-5505
US

V. Phone/Fax

Practice location:
  • Phone: 702-757-1599
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GEORGE GANGE
Title or Position: PRESIDENT
Credential:
Phone: 702-757-1331