Organization
FARMACIA DEL PUEBLO INC
Active
Other names
FARMACIA DEL PUEBLO
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER TYLER PHARM.D. (PRESIDENT)
(702) 544-3998
Entity
Organization
Contact information
Practice address
2123 CIVIC CENTER DR, NORTH LAS VEGAS, NV 89030-6327
(702) 399-9477
(702) 399-7570
Mailing address
2644 KINGHORN PL, HENDERSON, NV 89044-8796
(702) 544-3998
(702) 616-7087
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH02238
NV
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100512761
—
NV
01
—
2990629
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/22/2007
Last updated
05/22/2012
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