MEDICARE: TEGEST TILAHUN

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	20171	NV

General Provider Information

NPI Number	:	1093504912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TEGEST TILAHUN

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	:	703-331-6388
Fax Number	:

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

Provider Enumeration Date	:	05/06/2025
Last Update Date	:	05/06/2025

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Directions to “ TEGEST TILAHUN ” Practice Location

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