Organization
WELL CARE PHARMACY I, LLC
Active
Other names
McCarran Pharmacy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MARCELINO CASAL RPH (PRESIDENT, CEO)
(818) 468-6355
Entity
Organization
Contact information
Practice address
5757 WAYNE NEWTON BLVD, LAS VEGAS, NV 89111-8037
(702) 576-9545
(702) 946-0353
Mailing address
4101 WAGON TRAIL AVE, LAS VEGAS, NV 89118-4426
(702) 946-0353
(702) 946-0353
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH03164
NV
Other
Enumeration date
05/08/2014
Last updated
05/08/2014
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