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NPI Code Detail

MEDICARE: CONSONUS PHARMACY SERVICES LLC

MEDICARE: CONSONUS PHARMACY SERVICES 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
1333600000XPharmacy
23336C0004XCompounding Pharmacy
33336L0003XLong Term Care PharmacyPH03561NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12159603OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144674250
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONSONUS PHARMACY SERVICES LLC
Provider Business Mailing Address
First Line : 4560 SE INTERNATIONAL WAY STE 101
Second Line : SUITE 101
City : MILWAUKIE
State : OR
Zip : 97222-4628
Country : US
Telephone Number : 877-311-1499
Fax Number : 503-961-7781
Provider Business Practice Location Address
First Line : 6351 N FORT APACHE RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89149-2300
Country : US
Telephone Number : 702-515-4180
Fax Number : 503-961-7781
Authorized Official
Title or Position : VP OF FINANCE
Name : TAMI LAFLEN
Credential :
Telephone Number : 971-206-5172
Provider Enumeration Date : 04/15/2016
Last Update Date : 09/19/2025

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Directions to “CONSONUS PHARMACY SERVICES LLC ” Practice Location

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