Organization
INDIGO PHARMACEUTICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC SPARKS PHARMD (PHARMACY MANAGER)
(702) 427-0707
Entity
Organization
Contact information
Practice address
270 S MARTIN LUTHER KING BLVD, LAS VEGAS, NV 89106-4305
(954) 557-0061
Mailing address
270 S MARTIN LUTHER KING BLVD, LAS VEGAS, NV 89106-4305
(954) 557-0061
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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