MEDICARE: KENNETH EARL SEARLES

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
1	183500000X	Pharmacist	06933	NV

General Provider Information

NPI Number	:	1063171619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH EARL SEARLES

Provider Business Mailing Address
First Line	:	2310 W WINDSONG LN
Second Line	:
City	:	PAHRUMP
State	:	NV
Zip	:	89048-4425
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 E NEVADA HIGHWAY 372 STE E
Second Line	:
City	:	PAHRUMP
State	:	NV
Zip	:	89048-4671
Country	:	US
Telephone Number	:	775-727-3905
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2021
Last Update Date	:	12/10/2021

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Directions to “ KENNETH EARL SEARLES ” Practice Location

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