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General NPI Number Information
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NPI Number | 1144643305
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Entity Type | Organization
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Legal Business Name | WELL CARE APOTHECARY, LLC
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Dates
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Enumeration Date | 01/23/2014
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Last Update Date | 04/17/2024
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Provider Practice Location Address
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Address Line | 3300 W CHARLESTON BLVD STE B
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City | LAS VEGAS
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State | NV
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Zip | 89102-1829
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Country | US
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Telephone | 702-410-7801
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Fax | 702-988-8806
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Provider Business Mailing Address
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Address Line | 3312 W CHARLESTON BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89102-1829
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Country | US
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Telephone | 702-410-7825
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Fax | 702-946-0409
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | VANESSA ROBERTS
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Credential |
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Telephone | 702-410-7801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHC03076
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PH03076
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License Number State | NV
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