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General NPI Number Information
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NPI Number | 1205986528
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Entity Type | Organization
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Legal Business Name | LAS VEGAS PAIUTE TRIBE CLINIC
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 09/30/2016
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Provider Practice Location Address
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Address Line | 1257 PAIUTE CIR
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City | LAS VEGAS
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State | NV
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Zip | 89106-3202
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Country | US
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Telephone | 702-382-0784
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Fax | 702-366-0999
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Provider Business Mailing Address
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Address Line | 1257 PAIUTE CIR
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City | LAS VEGAS
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State | NV
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Zip | 89106-3202
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Country | US
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Telephone | 702-382-0784
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Fax | 702-366-0999
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Authorized Official
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Title or Position | PHRM MANG
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Name | SHARONA SOLEYMANI
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Credential | RPH
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Telephone | 702-382-0784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332800000X
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Taxonomy Name | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
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License Number |
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License Number State |
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