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Organization

C & R PHARMACY

Active
Other names
Ken's Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
KENNETH HEATON RPH (PRESIDENT)
(702) 384-3784
Entity
Organization

Contact information

Practice address
2202 W CHARLESTON BLVD, STE 13, LAS VEGAS, NV 89102-2232
(702) 384-3784
(702) 384-3796
Mailing address
2202 W CHARLESTON BLVD, STE 13, LAS VEGAS, NV 89102-2232
(702) 384-3784
(702) 384-3796

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0004X
Compounding Pharmacy
3336L0003X
Long Term Care Pharmacy
Primary
PH02759
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100526901
NV
01
2133755
PK
Enumeration date
02/02/2012
Last updated
01/18/2017
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