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General NPI Number Information
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NPI Number | 1174334197
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Entity Type | Individual
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Provider Name | STEVEN LY PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 2845 ETHELINDA WAY
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City | RENO
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State | NV
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Zip | 89521-4395
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Country | US
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Telephone | 775-721-1395
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Fax |
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Provider Business Mailing Address
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Address Line | 5401 LONGLEY LN STE 34
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City | RENO
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State | NV
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Zip | 89511-1817
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Country | US
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Telephone | 775-721-1395
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Fax | 775-470-8478
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 20148
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License Number State | NV
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