NPI 1184162844

Jolly's Drug Store LLC

Organisation Pharmacy Alamo, NV

Practice location

Address: 414 Broadway, Alamo, NV 89001
Phone: (775) 725-3515
Fax: (775) 725-3518
Mailing address: PO Box 1011, Caliente, NV 89008-1011

Authorised official

Name: Jonathan Heaton
Title: Owner
Phone: (801) 358-9608

Registered specialties

Pharmacy Primary

Suppliers Taxonomy 333600000X Licence PH03674 (NV)

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Registry record

NPI: 1184162844
Entity type: Organization
NPI issued: 2 Feb 2017
Record last updated: 2 Feb 2017

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.