MEDICARE: HOLLY PRIEVO RPH

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	15932	NV

General Provider Information

NPI Number	:	1740891746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY PRIEVO RPH

Provider Business Mailing Address
First Line	:	5888 W SUNSET RD STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-3453
Country	:	US
Telephone Number	:	702-889-8274
Fax Number	:	702-889-8287

Provider Business Practice Location Address
First Line	:	5888 W SUNSET RD STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-3453
Country	:	US
Telephone Number	:	702-889-8274
Fax Number	:	702-889-8287

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

Provider Enumeration Date	:	08/12/2020
Last Update Date	:	08/12/2020

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Directions to “ HOLLY PRIEVO RPH” Practice Location

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