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NPI Code Detail

MEDICARE: MRS. DEBRA ANN DIRISIO RPH

MEDICARE: MRS. DEBRA ANN DIRISIO 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
1183500000XPharmacist8837NV

General Provider Information

NPI Number : 1235446386
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEBRA ANN DIRISIO RPH
Provider Business Mailing Address
First Line : 6555 N DECATUR BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89131-2796
Country : US
Telephone Number : 702-415-2328
Fax Number : 702-415-2325
Provider Business Practice Location Address
First Line : 6555 N DECATUR BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89131-2796
Country : US
Telephone Number : 702-415-2328
Fax Number : 702-415-2325
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2010
Last Update Date : 09/10/2010

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Directions to “ MRS. DEBRA ANN DIRISIO RPH” Practice Location

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