Organization
PRECISION SPECIALTY PHARMACY
Active
Other names
Precision Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY GREEN (PHARMACIST)
(702) 405-9500
Entity
Organization
Contact information
Practice address
2775 S JONES BLVD STE 100A, LAS VEGAS, NV 89146-5655
(702) 405-9500
Mailing address
2775 S JONES BLVD, SUITE 100A, LAS VEGAS, NV 89146-5631
(702) 405-9500
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
PH02705
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2992659
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/14/2011
Last updated
06/14/2011
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