NPI 1164704326

Walgreens Pharmacy

Organisation Health Maintenance Organization Las Vegas, NV

Practice location

Address: 6101 W Lake Mead Blvd, Las Vegas, NV 89108-2660
Phone: (702) 648-2732
Fax: (702) 648-2509
Mailing address: 6080 W Gowan Rd, Las Vegas, NV 89108-4816

Authorised official

Name: Tanasorn Fowler
Title: Pharmacist
Phone: (702) 648-2732

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence 16568 (NV)

Other Health Maintenance Organization providers in Nevada →

Registry record

NPI: 1164704326
Entity type: Organization
NPI issued: 14 Sep 2011
Record last updated: 14 Sep 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.