MEDICARE: COMMUNITY REACH 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	:	1639009541
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY REACH PHARMACY LLC

Provider Business Mailing Address
First Line	:	2508 E OWENS AVE UNIT 1
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-7215
Country	:	US
Telephone Number	:	702-350-0543
Fax Number	:

Provider Business Practice Location Address
First Line	:	2508 E OWENS AVE UNIT 1
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-7215
Country	:	US
Telephone Number	:	702-350-0543
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALEXANDRE BAGDASSARIAN
Credential	:
Telephone Number	:	702-350-0543

Provider Enumeration Date	:	05/21/2026
Last Update Date	:	05/21/2026

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Directions to “COMMUNITY REACH PHARMACY LLC ” Practice Location

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