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NPI Code Detail

MEDICARE: RAXO DRUG INC

MEDICARE: RAXO DRUG INC
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
1332B00000XDurable Medical Equipment & Medical Supplies
23336C0003XCommunity/Retail PharmacyPH01034NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12050823OTHERPK

General Provider Information

NPI Number : 1437312964
Entity Type Code : Organization
Provider Name (Legal Business Name) : RAXO DRUG INC
Provider Business Mailing Address
First Line : 3199 S EASTERN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-3308
Country : US
Telephone Number : 702-369-9135
Fax Number : 702-369-6920
Provider Business Practice Location Address
First Line : 3199 S EASTERN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-3308
Country : US
Telephone Number : 702-369-9135
Fax Number : 702-369-6920
Authorized Official
Title or Position : OWNER
Name : SHARAF HASSEEBULLAH
Credential :
Telephone Number : 702-219-0866
Provider Enumeration Date : 07/03/2008
Last Update Date : 10/06/2014

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Directions to “RAXO DRUG INC ” Practice Location

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