Healthcare Provider Details

I. General information

NPI: 1497914162
Provider Name (Legal Business Name): SNAMHS DOWNTOWN PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2008
Last Update Date: 06/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 S 7TH ST
LAS VEGAS NV
89101-6932
US

IV. Provider business mailing address

720 S 7TH ST
LAS VEGAS NV
89101-6932
US

V. Phone/Fax

Practice location:
  • Phone: 702-668-4700
  • Fax: 702-668-4701
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License NumberPH02268
License Number StateNV

VIII. Authorized Official

Name: OBIDIKE IHEANACHO
Title or Position: MANAGER
Credential:
Phone: 702-668-4702