MEDICARE: DR. HECTOR BURGARA JR. PHARMD

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	183500000X	Pharmacist	S025322	AZ

General Provider Information

NPI Number	:	1376219493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HECTOR BURGARA JR. PHARMD

Provider Business Mailing Address
First Line	:	5618 MIDNIGHT BREEZE ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-3015
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4747 HWY 95
Second Line	:
City	:	FORT MOHAVE
State	:	AZ
Zip	:	86426-9377
Country	:	US
Telephone Number	:	928-251-7045
Fax Number	:	833-874-1887

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2021
Last Update Date	:	05/17/2026

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