=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962730168
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UNIQUE CARE PHARMACY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/27/2009
-----------------------------------------------------
Last Update Date | 11/24/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4571 W FLAMINGO RD
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89103-3702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-522-9777
-----------------------------------------------------
Fax | 702-522-9779
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4571 W FLAMINGO RD
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89103-3702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-522-9777
-----------------------------------------------------
Fax | 702-522-9779
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/CEO
-----------------------------------------------------
Name | CHIDI ONYIRIMBA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 702-525-3297
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | PH02585
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------