MEDICARE: JOCELYN S SANTIAGO

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	15240	NV

General Provider Information

NPI Number	:	1962789982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOCELYN S SANTIAGO

Provider Business Mailing Address
First Line	:	3668 GREENFIELD LAKES ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89122-4108
Country	:	US
Telephone Number	:	702-457-6080
Fax Number	:

Provider Business Practice Location Address
First Line	:	4895 BOULDER HWY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-3012
Country	:	US
Telephone Number	:	702-898-5264
Fax Number	:	702-898-5274

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

Provider Enumeration Date	:	11/04/2011
Last Update Date	:	11/04/2011

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Directions to “ JOCELYN S SANTIAGO ” Practice Location

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