Healthcare Provider Details

I. General information

NPI: 1780771972
Provider Name (Legal Business Name): OP PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2006
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 E WARM SPRINGS RD STE 112
LAS VEGAS NV
89119-4200
US

IV. Provider business mailing address

805 N WHITTINGTON PKWY STE 400
LOUISVILLE KY
40222-7101
US

V. Phone/Fax

Practice location:
  • Phone: 702-777-4911
  • Fax: 702-777-4912
Mailing address:
  • Phone: 502-627-7100
  • Fax: 855-217-7498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ALLISON L. BROWN
Title or Position: SECRETARY
Credential:
Phone: 502-630-7429