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General NPI Number Information
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NPI Number | 1245056381
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Entity Type | Organization
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Legal Business Name | FAMILY MEDICAL PHARMACY, LLC
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Dates
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Enumeration Date | 11/22/2024
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 1825 CIVIC CENTER DR
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89030-7113
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Country | US
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Telephone | 312-545-3805
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Fax | 725-258-8757
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Provider Business Mailing Address
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Address Line | 1825 CIVIC CENTER DR
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89030-7113
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Country | US
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Telephone | 312-545-3805
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Fax | 725-258-8757
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Authorized Official
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Title or Position | PHARMACIST
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Name | KARL STEPHEN VILLALUZ
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Credential | RPH
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Telephone | 312-545-3805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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