MEDICARE: JOSHUA GAINEY

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	20225	NV
2	163WP0807X	Child & Adolescent Psychiatric/Mental Health Registered Nurse	RN71078	NV

General Provider Information

NPI Number	:	1225661002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA GAINEY

Provider Business Mailing Address
First Line	:	9238 BLUEMIST FALLS ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-3249
Country	:	US
Telephone Number	:	913-232-6076
Fax Number	:

Provider Business Practice Location Address
First Line	:	6171 W CHARLESTON BLVD BLDG 14
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-1126
Country	:	US
Telephone Number	:	702-668-4747
Fax Number	:

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

Provider Enumeration Date	:	02/19/2020
Last Update Date	:	01/05/2021

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Directions to “ JOSHUA GAINEY ” Practice Location

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