Organization
SIERRA COMPOUNDING PHARMACY
Active
Other names
Hale's Phramacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRANT SKANSON (PRESIDENT)
(775) 853-3500
Entity
Organization
Contact information
Practice address
901 E 2ND ST, STE 102, RENO, NV 89502-1175
(775) 322-2171
(775) 322-8902
Mailing address
901 E 2ND ST, STE 102, RENO, NV 89502-1175
(775) 322-2171
(775) 322-8902
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH00734
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2993055
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/27/2012
Last updated
08/27/2012
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