MEDICARE: WELL CARE PHARMACY I, LLC SERIES A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	251S00000X	Community/Behavioral Health Agency
3	1835P1200X	Pharmacotherapy Pharmacist

General Provider Information

NPI Number	:	1295106987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELL CARE PHARMACY I, LLC SERIES A

Provider Business Mailing Address
First Line	:	3312 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1829
Country	:	US
Telephone Number	:	702-410-7825
Fax Number	:	702-946-0409

Provider Business Practice Location Address
First Line	:	5446 BOULDER HWY STE G3
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89122-6069
Country	:	US
Telephone Number	:	702-291-7121
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	ROYA BEUOKAGHAEI
Credential	:	MANAGER
Telephone Number	:	702-410-7825

Provider Enumeration Date	:	10/07/2015
Last Update Date	:	04/17/2024

Similar Medicare Providers

1114402633 — CHRISTOPHER GRANT
Practice Location Address:

5446 BOULDER HWY # G3
LAS VEGAS, NV
89122-6069

Practice Phone: 702-291-7121
Practice Fax:

1720550510 — ANTIONE L LEONARD SR.
Practice Location Address:

5446 BOULDER HWY
LAS VEGAS, NV
89122-6069

Practice Phone: 702-291-7121
Practice Fax:

1669092458 — MEDTRANS
Practice Location Address:

5446 BOULDER HWY STE G3
LAS VEGAS, NV
89122-6069

Practice Phone: 702-291-7121
Practice Fax:

1972808764 — MISS MARLENNY CHAIDEZ
Practice Location Address:

4216 THUNDER TWICE ST
LAS VEGAS, NV
89129-6069

Practice Phone: 702-497-4622
Practice Fax:

1578959417 — MRS. JENNA LEIGH CLIFFORD LCSW
Practice Location Address:

6069 S FORT APACHE RD STE 100
LAS VEGAS, NV
89148-5579

Practice Phone: 702-410-2649
Practice Fax:

1952798407 — CROSSROADS BEHAVIORAL HEALTHCARE
Practice Location Address:

6069 S FORT APACHE RD , SUITE 100
LAS VEGAS, NV
89148-5647

Practice Phone: 702-410-2631
Practice Fax:

Directions to “WELL CARE PHARMACY I, LLC SERIES A ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.