Organization
C & R PHARMACY
Active
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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