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Organization

NEVADA FAMILY PRACTICE RESIDENCE PROGRAM

Active
Other names
Campus Pharmacy III
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KENNETH J. RYAN RPH (PHARMACIST/MANAGER)
(702) 968-4038
Entity
Organization

Contact information

Practice address
4000 E CHARLESTON BLVD, B-130, LAS VEGAS, NV 89104-6659
(702) 968-4038
(702) 968-4033
Mailing address
4000 E CHARLESTON BLVD, B-130, LAS VEGAS, NV 89104-6659
(702) 968-4038
(702) 968-4033

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PH1189
NV

Other

Enumeration date
03/15/2006
Last updated
10/05/2010
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