Healthcare Provider Details

I. General information

NPI: 1487978136
Provider Name (Legal Business Name): FVS HOLDINS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2010
Last Update Date: 05/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6370 W FLAMINGO RD STE 1
LAS VEGAS NV
89103-2274
US

IV. Provider business mailing address

6370 W FLAMINGO RD STE 1
LAS VEGAS NV
89103-2274
US

V. Phone/Fax

Practice location:
  • Phone: 702-365-6100
  • Fax:
Mailing address:
  • Phone: 702-365-6100
  • Fax:

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 TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License NumberPH02596
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GLENN TRUITT
Title or Position: SENIOR VP
Credential:
Phone: 702-564-2079