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NPI Code Detail

MEDICARE: UHS RETAIL PHARMACY LLC

MEDICARE: UHS RETAIL 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
1333600000XPharmacy
23336M0002XMail Order PharmacyPH03261NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12157991OTHERPK

General Provider Information

NPI Number : 1275931404
Entity Type Code : Organization
Provider Name (Legal Business Name) : UHS RETAIL PHARMACY LLC
Provider Business Mailing Address
First Line : 2345 E PRATER WAY STE 111
Second Line :
City : SPARKS
State : NV
Zip : 89434-9664
Country : US
Telephone Number : 775-432-7907
Fax Number : 775-343-0102
Provider Business Practice Location Address
First Line : 2345 E PRATER WAY STE 111
Second Line :
City : SPARKS
State : NV
Zip : 89434-9664
Country : US
Telephone Number : 775-432-7908
Fax Number : 775-343-0107
Authorized Official
Title or Position : CEO
Name : MARVIN PEMBER
Credential : BSC PHARMACY
Telephone Number : 610-302-3300
Provider Enumeration Date : 12/22/2014
Last Update Date : 01/23/2017

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Directions to “UHS RETAIL PHARMACY LLC ” Practice Location

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