MEDICARE: CAPITAL CARE PHARMACY LLC

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	3336L0003X	Long Term Care Pharmacy
2	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1275398414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPITAL CARE PHARMACY LLC

Provider Business Mailing Address
First Line	:	5693 S JONES BLVD STE 119
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1967
Country	:	US
Telephone Number	:	702-844-8445
Fax Number	:	702-780-5990

Provider Business Practice Location Address
First Line	:	5693 S JONES BLVD STE 119
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1967
Country	:	US
Telephone Number	:	702-844-8445
Fax Number	:	702-780-5990

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MARK YU
Credential	:
Telephone Number	:	702-844-8445

Provider Enumeration Date	:	02/16/2024
Last Update Date	:	05/07/2024

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Directions to “CAPITAL CARE PHARMACY LLC ” Practice Location

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