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General NPI Number Information
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NPI Number | 1982341475
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Entity Type | Organization
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Legal Business Name | COMPLETE CARE PHARMACY & MEDICAL SUPPLY INC
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Dates
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Enumeration Date | 05/16/2022
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 2080 E FLAMINGO RD STE 302
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City | LAS VEGAS
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State | NV
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Zip | 89119-5180
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Country | US
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Telephone | 702-983-2243
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Fax | 725-550-8444
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Provider Business Mailing Address
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Address Line | 2080 E FLAMINGO RD STE 302
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City | LAS VEGAS
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State | NV
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Zip | 89119-5180
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Country | US
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Telephone | 702-983-2243
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Fax | 725-550-8444
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Authorized Official
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Title or Position | CONTRACTING & LICENSING SPECIALIST
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Name | TAMMY FREEMAN
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Credential |
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Telephone | 702-983-2243
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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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