Healthcare Provider Details

I. General information

NPI: 1639779002
Provider Name (Legal Business Name): CODY J STOCKS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2020
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 N SANDHILL BLVD
MESQUITE NV
89027-4797
US

IV. Provider business mailing address

350 N SANDHILL BLVD
MESQUITE NV
89027-4797
US

V. Phone/Fax

Practice location:
  • Phone: 702-803-7940
  • Fax: 702-690-2869
Mailing address:
  • Phone: 702-803-7940
  • Fax: 702-690-2869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number24690
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number80809631701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: