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General NPI Number Information
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NPI Number | 1679391460
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Entity Type | Organization
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Legal Business Name | DISTRICT PHARMACY CORPORATION
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 1807 W CHARLESTON BLVD STE 110
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City | LAS VEGAS
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State | NV
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Zip | 89102-2323
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Country | US
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Telephone | 408-504-3193
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Fax |
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Provider Business Mailing Address
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Address Line | 2505 ANTHEM VILLAGE DR STE E460
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City | HENDERSON
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State | NV
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Zip | 89052-5505
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GEORGE GANGE
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Credential |
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Telephone | 408-504-3193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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