MEDICARE: US PHARMACY LLC

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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1568115608
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	US PHARMACY LLC

Provider Business Mailing Address
First Line	:	3871 S VALLEY VIEW BLVD STE 13
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-2962
Country	:	US
Telephone Number	:	702-916-4622
Fax Number	:	702-916-4623

Provider Business Practice Location Address
First Line	:	3871 S VALLEY VIEW BLVD STE 13
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-2962
Country	:	US
Telephone Number	:	702-916-4622
Fax Number	:	702-916-4623

Authorized Official
Title or Position	:	OWNER
Name	:	TANIA PRIETO HERNANDEZ
Credential	:
Telephone Number	:	702-788-0486

Provider Enumeration Date	:	01/29/2022
Last Update Date	:	05/17/2022

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Directions to “US PHARMACY LLC ” Practice Location

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