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NPI Code Detail

MEDICARE: ADVANCED CARE RX PHARMACY

MEDICARE: ADVANCED CARE RX PHARMACY
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
13336C0004XCompounding PharmacyPH02583NV
23336C0003XCommunity/Retail PharmacyPH02583NV

General Provider Information

NPI Number : 1447581913
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED CARE RX PHARMACY
Provider Business Mailing Address
First Line : 840 E TWAIN AVE STE 137
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-4025
Country : US
Telephone Number : 702-272-2709
Fax Number : 702-405-0673
Provider Business Practice Location Address
First Line : 840 E TWAIN AVE STE 137
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-4025
Country : US
Telephone Number : 702-272-2709
Fax Number : 702-405-0673
Authorized Official
Title or Position : OWNER
Name : EGHE JERRY IGBINOVIA
Credential : PHARM. D
Telephone Number : 702-595-6265
Provider Enumeration Date : 01/23/2010
Last Update Date : 01/23/2010

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Directions to “ADVANCED CARE RX PHARMACY ” Practice Location

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