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General NPI Number Information
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NPI Number | 1841948767
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Entity Type | Organization
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Legal Business Name | FIDUCIARYRX, LLC
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Dates
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Enumeration Date | 03/10/2022
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Last Update Date | 03/10/2022
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Provider Practice Location Address
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Address Line | 10845 GRIFFITH PEAK DR STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89135-1568
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Country | US
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Telephone | 866-499-1940
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Fax | 775-432-6262
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Provider Business Mailing Address
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Address Line | 10845 GRIFFITH PEAK DR STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89135-1568
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Country | US
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Telephone | 866-499-1940
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Fax | 775-432-6262
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | TYRONE D SQUIRES
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Credential |
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Telephone | 866-499-1940
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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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