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NPI Code Detail

MEDICARE: DR. KARL STEPHEN VILLALUZ RPH

MEDICARE: DR. KARL STEPHEN VILLALUZ 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
13336C0003XCommunity/Retail Pharmacy23374NV
23336C0003XCommunity/Retail PharmacyP10621ID

General Provider Information

NPI Number : 1740973908
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KARL STEPHEN VILLALUZ RPH
Provider Business Mailing Address
First Line : 1825 CIVIC CENTER DR
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-7113
Country : US
Telephone Number : 312-545-3805
Fax Number :
Provider Business Practice Location Address
First Line : 1825 CIVIC CENTER DR
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-7113
Country : US
Telephone Number : 312-545-3805
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2023
Last Update Date : 02/03/2024

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