MEDICARE: DR. TIMOTHY PETER STANCIU PHARMD

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	20877	NV

General Provider Information

NPI Number	:	1164195301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY PETER STANCIU PHARMD

Provider Business Mailing Address
First Line	:	105 ROCK CROSSING AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-1303
Country	:	US
Telephone Number	:	702-480-9914
Fax Number	:

Provider Business Practice Location Address
First Line	:	6371 N DECATUR BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-8001
Country	:	US
Telephone Number	:	702-515-8541
Fax Number	:

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

Provider Enumeration Date	:	07/25/2021
Last Update Date	:	07/25/2021

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