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General NPI Number Information
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NPI Number | 1841786415
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Entity Type | Organization
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Legal Business Name | LAS VEGAS SCRIPTS RX LLC.
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Dates
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Enumeration Date | 07/07/2018
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Last Update Date | 04/12/2019
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Provider Practice Location Address
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Address Line | 2920 N GREEN VALLEY PKWY STE 814
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City | HENDERSON
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State | NV
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Zip | 89014
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Country | US
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Telephone | 833-834-2779
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Fax | 833-834-2780
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Provider Business Mailing Address
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Address Line | 2920 N GREEN VALLEY PKWY STE 814
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City | HENDERSON
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State | NV
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Zip | 89014-0409
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Country | US
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Telephone | 702-832-3600
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Fax | 702-832-5733
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Authorized Official
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Title or Position | C.E.O.
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Name | DR. NATHAN EDOUARD
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Credential | PHARM D.
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Telephone | 702-832-3600
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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 | 19462
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | 19462
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License Number State | NV
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