MEDICARE: JUBDATUL AREFIN PHARM-D

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	18911	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	18911	OTHER	NV	NEVADA BOARD OF PHARMACY

General Provider Information

NPI Number	:	1770191579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUBDATUL AREFIN PHARM-D

Provider Business Mailing Address
First Line	:	4575 DEAN MARTIN DR UNIT 2206
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-8209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5850 W CRAIG RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-2558
Country	:	US
Telephone Number	:	702-395-1240
Fax Number	:

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

Provider Enumeration Date	:	07/17/2020
Last Update Date	:	08/03/2020

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Directions to “ JUBDATUL AREFIN PHARM-D” Practice Location

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