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LIFECARE PHARMACY, LLC

Managed Care Organization Pharmacy

Las Vegas, Nevada

Provider NPI: 1750788816

Organization Information:
Organization Name:  LIFECARE PHARMACY, LLC


Practice Location:
3050 E DESERT INN RD STE 124 LAS VEGAS, NV 89121 US
Tel: 702-697-2105  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N332B00000XSuppliers
Durable Medical Equipment & Medical Supplies
N333600000XSuppliers
Pharmacy
N3336M0003XSuppliers
Pharmacy
Y3336S0011XSuppliers
Pharmacy
NVPH01798

Other Provider Identifiers:

IssuerNumberStateType
PK214910401
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MANAGED CARE JOBS NV - Page 1



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