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General NPI Number Information
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NPI Number | 1669725099
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Entity Type | Organization
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Legal Business Name | NURO PHARMA INC
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Dates
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Enumeration Date | 10/23/2012
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Last Update Date | 09/10/2013
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Provider Practice Location Address
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Address Line | 6380 POLARIS AVE UNIT B
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City | LAS VEGAS
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State | NV
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Zip | 89118-3821
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Country | US
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Telephone | 949-351-6242
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Fax |
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Provider Business Mailing Address
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Address Line | 6380 POLARIS AVE UNIT B
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City | LAS VEGAS
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State | NV
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Zip | 89118-3821
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Country | US
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Telephone | 949-351-6242
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES FARES
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Credential |
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Telephone | 702-269-1941
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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 | PH02872
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License Number State | NV
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