MEDICARE: MEDTRUST PHARMACY 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
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1164175519
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDTRUST PHARMACY LLC

Provider Business Mailing Address
First Line	:	3375 E RUSSELL RD # 1G
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3472
Country	:	US
Telephone Number	:	702-331-3414
Fax Number	:	702-331-3413

Provider Business Practice Location Address
First Line	:	3375 E RUSSELL RD # 1G
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3472
Country	:	US
Telephone Number	:	702-331-3414
Fax Number	:	702-331-3413

Authorized Official
Title or Position	:	CEO
Name	:	MAHMOUD MOHAMED NOURELDEEN
Credential	:
Telephone Number	:	702-331-3414

Provider Enumeration Date	:	01/26/2022
Last Update Date	:	04/04/2025

Similar Medicare Providers

1548681943 — BRAND NEW HORIZON INC
Practice Location Address:

4029 BONITA DESERT CT
NORTH LAS VEGAS, NV
89032-3472

Practice Phone: 702-580-5991
Practice Fax:

1023520723 — IESHA CHANEY
Practice Location Address:

4175 N RANCHO DR STE 160
LAS VEGAS, NV
89130-3472

Practice Phone: 702-601-4747
Practice Fax:

1598312894 — F.A.I.T.H. BEHAVIORAL SERVICES AND WELLNESS CENTER
Practice Location Address:

4175 N RANCHO DR STE 160
LAS VEGAS, NV
89130-3472

Practice Phone: 702-331-0951
Practice Fax:

1306215843 — KARMIN JEMARIE RODRIGUEZ RIOS
Practice Location Address:

147 CALLE MADAGASCAR
LAS PIEDRAS, PR
00771-3472

Practice Phone: 787-505-7571
Practice Fax:

1396617593 — CHRIS PROMPRASERT
Practice Location Address:

7385 S PECOS RD
LAS VEGAS, NV
89120-3768

Practice Phone: 702-796-4278
Practice Fax: 702-734-2650

1346190949 — ADAUGO MIRACLE OSUCHUKWU
Practice Location Address:

3161 E WARM SPRINGS RD STE 100
LAS VEGAS, NV
89120-3144

Practice Phone: 718-552-0014
Practice Fax:

Directions to “MEDTRUST PHARMACY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.