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General NPI Number Information
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NPI Number | 1609651942
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Entity Type | Organization
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Legal Business Name | QUALITY COMPOUNDING RX OF AMERICA
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Dates
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Enumeration Date | 08/25/2023
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Last Update Date | 08/25/2023
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Provider Practice Location Address
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Address Line | 801 S RANCHO DR STE E7
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City | LAS VEGAS
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State | NV
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Zip | 89106-3812
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Country | US
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Telephone | 702-984-6640
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Fax | 702-202-3420
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Provider Business Mailing Address
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Address Line | 801 S RANCHO DR STE E7
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City | LAS VEGAS
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State | NV
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Zip | 89106-3812
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Country | US
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Telephone | 702-984-6640
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Fax | 702-202-3420
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | DR. JUBDATUL AREFIN
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Credential | PHARMD
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Telephone | 702-984-6640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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