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General NPI Number Information
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NPI Number | 1245983675
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Entity Type | Organization
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Legal Business Name | GREENLEAF PHARMACY LLC
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Dates
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Enumeration Date | 01/26/2022
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Last Update Date | 01/26/2022
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Provider Practice Location Address
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Address Line | 3483 S EASTERN AVE STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89169-3314
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Country | US
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Telephone | 725-254-3210
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Fax |
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Provider Business Mailing Address
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Address Line | 3483 S EASTERN AVE STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89169-3314
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Country | US
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Telephone | 725-254-3210
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | PARAG PATEL
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Credential |
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Telephone | 443-616-7285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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