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NPI Code Detail

MEDICARE: RYAN'S PHARMACY

MEDICARE: RYAN'S PHARMACY
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
1183500000XPharmacist15925NV
23336C0003XCommunity/Retail PharmacyPH02239NV

General Provider Information

NPI Number : 1104037548
Entity Type Code : Organization
Provider Name (Legal Business Name) : RYAN'S PHARMACY
Provider Business Mailing Address
First Line : 150 E HARMON AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109
Country : US
Telephone Number : 702-650-0445
Fax Number : 702-650-0615
Provider Business Practice Location Address
First Line : 150 E HARMON AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-4533
Country : US
Telephone Number : 702-650-0445
Fax Number : 702-650-0615
Authorized Official
Title or Position : PRESIDENT, OWNER
Name : MR. RYAN OBREGON
Credential : RPH
Telephone Number : 323-707-6707
Provider Enumeration Date : 05/25/2007
Last Update Date : 02/25/2009

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Directions to “RYAN'S PHARMACY ” Practice Location

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