MEDICARE: IRIS KHUMALO-MUSAH

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	19747	NV

General Provider Information

NPI Number	:	1770164840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRIS KHUMALO-MUSAH

Provider Business Mailing Address
First Line	:	4845 S RAINBOW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-4916
Country	:	US
Telephone Number	:	702-538-9388
Fax Number	:

Provider Business Practice Location Address
First Line	:	4845 S RAINBOW BLVD STE 403
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-4750
Country	:	US
Telephone Number	:	702-849-7668
Fax Number	:

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

Provider Enumeration Date	:	04/19/2021
Last Update Date	:	05/29/2023

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Directions to “ IRIS KHUMALO-MUSAH ” Practice Location

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