Healthcare Provider Details

I. General information

NPI: 1053858480
Provider Name (Legal Business Name): ACRX SPECIALTY PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2017
Last Update Date: 01/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 SOARING GULLS DR STE 101
LAS VEGAS NV
89129-2198
US

IV. Provider business mailing address

3200 SOARING GULLS DR SUITE 101
LAS VEGAS NV
89129-2198
US

V. Phone/Fax

Practice location:
  • Phone: 702-800-6448
  • Fax:
Mailing address:
  • Phone: 702-800-6448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332800000X
TaxonomyIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License NumberPH03673
License Number StateNV

VIII. Authorized Official

Name: EGHOMWARE IGBINOVIA
Title or Position: OWNER
Credential:
Phone: 702-800-6448