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General NPI Number Information
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NPI Number | 1467085381
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Entity Type | Organization
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Legal Business Name | CMH PHARMACY LLC
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Dates
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Enumeration Date | 02/19/2020
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Last Update Date | 02/19/2020
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Provider Practice Location Address
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Address Line | 6445 W SUNSET RD STE 168
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City | LAS VEGAS
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State | NV
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Zip | 89118-3321
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Country | US
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Telephone | 725-780-1313
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Fax | 725-780-1318
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Provider Business Mailing Address
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Address Line | 6445 W SUNSET RD STE 168
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City | LAS VEGAS
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State | NV
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Zip | 89118-3321
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Country | US
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Telephone | 725-780-1313
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Fax | 725-780-1318
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Authorized Official
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Title or Position | PRINCIPAL
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Name | MR. ROBERT LIVELY JR.
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Credential |
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Telephone | 702-400-3139
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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 |
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License Number State |
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