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NPI Code Detail

MEDICARE: ADELINA VONGPANYA PHARMD

MEDICARE: ADELINA VONGPANYA 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
1183500000XPharmacist15995NV

General Provider Information

NPI Number : 1497976468
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADELINA VONGPANYA PHARMD
Provider Business Mailing Address
First Line : 7100 ARROYO CROSSING PKWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-4057
Country : US
Telephone Number : 702-260-6264
Fax Number : 702-260-6411
Provider Business Practice Location Address
First Line : 7100 ARROYO CROSSING PKWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-4057
Country : US
Telephone Number : 702-260-6264
Fax Number : 702-260-6411
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2007
Last Update Date : 08/16/2008

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Directions to “ ADELINA VONGPANYA PHARMD” Practice Location

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