Organization
FLYING DIAMOND PHARMACY LLC
Active
Other names
FLYING DIAMOND PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMARA W AVERA (OFFICE MANAGER)
(775) 787-1144
Entity
Organization
Contact information
Practice address
6140 MAE ANNE AVE STE 1B, RENO, NV 89523-4707
(775) 787-1144
(775) 787-1143
Mailing address
PO BOX 5326, RENO, NV 89513-5326
(775) 787-1144
(775) 787-1143
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PH02114
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174578124
—
NV
05
—
1275587867
—
NV
01
—
2052136
PK
—
Enumeration date
05/24/2006
Last updated
05/12/2025
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