MEDICARE: LOTUS 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
1	3336C0002X	Clinic Pharmacy

General Provider Information

NPI Number	:	1528811726
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOTUS PHARMACY

Provider Business Mailing Address
First Line	:	2031 MCDANIEL ST STE 200
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-6312
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2031 MCDANIEL ST STE 200
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-6312
Country	:	US
Telephone Number	:	702-294-0080
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER
Name	:	SHERIF AL HAWAREY
Credential	:	MD
Telephone Number	:	702-294-0080

Provider Enumeration Date	:	04/08/2024
Last Update Date	:	04/08/2024

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Directions to “LOTUS PHARMACY ” Practice Location

Language	Start Address	Practice Location

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