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NPI Code Detail

MEDICARE: QHR PHARMACY 1, LLC

MEDICARE: QHR PHARMACY 1, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail PharmacyPH03563NV

General Provider Information

NPI Number : 1053769703
Entity Type Code : Organization
Provider Name (Legal Business Name) : QHR PHARMACY 1, LLC
Provider Business Mailing Address
First Line : 765 N NELLIS BLVD STE 7
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-5391
Country : US
Telephone Number : 702-331-6388
Fax Number : 702-331-7791
Provider Business Practice Location Address
First Line : 765 N NELLIS BLVD STE 7
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-5391
Country : US
Telephone Number : 702-331-6388
Fax Number : 702-331-7791
Authorized Official
Title or Position : MANAGING OFFICER / OWNER
Name : MR. LEANDRO LAI HANG SETO
Credential :
Telephone Number : 702-331-6388
Provider Enumeration Date : 06/02/2016
Last Update Date : 05/12/2025

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