Healthcare Provider Details

I. General information

NPI: 1780695296
Provider Name (Legal Business Name): SPRING CREEK PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

568 SPRING VALLEY CT
SPRING CREEK NV
89815-6821
US

IV. Provider business mailing address

PO BOX 8270
SPRING CREEK NV
89815-0005
US

V. Phone/Fax

Practice location:
  • Phone: 775-777-9119
  • Fax: 775-777-3342
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH00969
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANGELA ATKINS
Title or Position: OWNER
Credential:
Phone: 775-777-9119