MEDICARE: DR. LUCAS FENGMING GUO PHARMD

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	21976	NV

General Provider Information

NPI Number	:	1982347662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUCAS FENGMING GUO PHARMD

Provider Business Mailing Address
First Line	:	7963 CARMEL HEIGHTS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-3809
Country	:	US
Telephone Number	:	702-477-5093
Fax Number	:

Provider Business Practice Location Address
First Line	:	3041 W HORIZON RIDGE PKWY STE 100
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-4444
Country	:	US
Telephone Number	:	702-778-8880
Fax Number	:

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

Provider Enumeration Date	:	04/19/2022
Last Update Date	:	04/19/2022

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