Healthcare Provider Details

I. General information

NPI: 1861741837
Provider Name (Legal Business Name): W CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2012
Last Update Date: 04/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4845 S RAINBOW BLVD STE 403
LAS VEGAS NV
89103-4750
US

IV. Provider business mailing address

4845 S RAINBOW BLVD STE 403
LAS VEGAS NV
89103-4916
US

V. Phone/Fax

Practice location:
  • Phone: 702-538-9388
  • Fax: 702-776-8982
Mailing address:
  • Phone: 702-538-9388
  • Fax: 702-776-8982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHC02855
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOHN OKOYE
Title or Position: OWNER/PHCY MANAGER
Credential:
Phone: 702-538-9388