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NPI Code Detail

MEDICARE: MRS. ELAINE BARTOLOME SANTIAGO

MEDICARE: MRS. ELAINE BARTOLOME SANTIAGO
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
1183500000XPharmacistNV13454NV

General Provider Information

NPI Number : 1245514744
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELAINE BARTOLOME SANTIAGO
Provider Business Mailing Address
First Line : 3036 PALACE GATE CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-2536
Country : US
Telephone Number : 702-871-1405
Fax Number : 702-871-1657
Provider Business Practice Location Address
First Line : 3480 S JONES BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-6709
Country : US
Telephone Number : 702-871-1405
Fax Number : 702-871-1657
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2011
Last Update Date : 10/03/2011

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Directions to “ MRS. ELAINE BARTOLOME SANTIAGO ” Practice Location

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