MEDICARE: ARISE PHARMACY LLC

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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1972459774
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARISE PHARMACY LLC

Provider Business Mailing Address
First Line	:	3399 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3312
Country	:	US
Telephone Number	:	725-735-6904
Fax Number	:	725-735-6907

Provider Business Practice Location Address
First Line	:	3399 S EASTERN AVE STE B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3312
Country	:	US
Telephone Number	:	725-735-6904
Fax Number	:	725-735-6907

Authorized Official
Title or Position	:	PHARMACIST
Name	:	MODUPE IROROBEJE
Credential	:
Telephone Number	:	954-663-1759

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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Directions to “ARISE PHARMACY LLC ” Practice Location

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