MEDICARE: COMPLETE CARE PHARMACY & MEDICAL SUPPLY INC

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	:	1982341475
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPLETE CARE PHARMACY & MEDICAL SUPPLY INC

Provider Business Mailing Address
First Line	:	2080 E FLAMINGO RD STE 302
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5180
Country	:	US
Telephone Number	:	702-983-2243
Fax Number	:	725-550-8444

Provider Business Practice Location Address
First Line	:	2080 E FLAMINGO RD STE 302
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5180
Country	:	US
Telephone Number	:	702-983-2243
Fax Number	:	725-550-8444

Authorized Official
Title or Position	:	CONTRACTING & LICENSING SPECIALIST
Name	:	TAMMY FREEMAN
Credential	:
Telephone Number	:	702-983-2243

Provider Enumeration Date	:	05/16/2022
Last Update Date	:	06/04/2025

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