Healthcare Provider Details

I. General information

NPI: 1700668274
Provider Name (Legal Business Name): ALL WESTCARE PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 10/18/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 S EASTERN AVE. SUITE 2411
LAS NV
89104
US

IV. Provider business mailing address

2401 S EASTERN AVE. SUITE 2411
LAS NV
89104
US

V. Phone/Fax

Practice location:
  • Phone: 702-629-2212
  • Fax: 702-629-1866
Mailing address:
  • Phone: 702-629-2212
  • Fax: 702-629-1866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TASHIN SHANAN
Title or Position: CEO
Credential: RPH
Phone: 714-924-2800