MEDICARE: DR. ALEXANDER CHRISTOPHER VISAN PHARMD., RPH

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	22756	NV

General Provider Information

NPI Number	:	1164161618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDER CHRISTOPHER VISAN PHARMD., RPH

Provider Business Mailing Address
First Line	:	10000 S MARYLAND PKWY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-5888
Country	:	US
Telephone Number	:	702-683-7153
Fax Number	:

Provider Business Practice Location Address
First Line	:	4001 S MARYLAND PKWY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-7556
Country	:	US
Telephone Number	:	702-732-1840
Fax Number	:

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

Provider Enumeration Date	:	06/02/2022
Last Update Date	:	04/24/2024

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