MEDICARE: WAHID HARRIS HABIB 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	22993	IA
2	183500000X	Pharmacist	19577	NV

General Provider Information

NPI Number	:	1487259016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WAHID HARRIS HABIB PHARMD

Provider Business Mailing Address
First Line	:	590 SIGNAL PEAK ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89138-1548
Country	:	US
Telephone Number	:	858-663-4144
Fax Number	:

Provider Business Practice Location Address
First Line	:	4014 S RAINBOW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-2011
Country	:	US
Telephone Number	:	702-873-5917
Fax Number	:

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

Provider Enumeration Date	:	12/01/2020
Last Update Date	:	12/01/2020

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Directions to “ WAHID HARRIS HABIB PHARMD” Practice Location

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