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NPI Code Detail

MEDICARE: TANYA JIZEL BALITA SAURA RPH

MEDICARE: TANYA JIZEL BALITA SAURA 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
1183500000XPharmacist23745NV

General Provider Information

NPI Number : 1255010823
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANYA JIZEL BALITA SAURA RPH
Provider Business Mailing Address
First Line : 10370 N MCCARRAN BLVD
Second Line :
City : RENO
State : NV
Zip : 89503-6848
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10370 N MCCARRAN BLVD
Second Line :
City : RENO
State : NV
Zip : 89503-6848
Country : US
Telephone Number : 775-746-4809
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2023
Last Update Date : 07/12/2023

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