Organization
UHS RETAIL PHARMACY LLC
Active
Other names
CentRx Pharmacy Spring Valley
Organization subpart
No
Provider details
NPI number
Authorized official
MARVIN PEMBER BSC PHARMACY (CEO)
(610) 302-3300
Entity
Organization
Contact information
Practice address
5400 S RAINBOW BLVD, LAS VEGAS, NV 89118-1859
(702) 425-4623
(469) 513-6121
Mailing address
5400 S RAINBOW BLVD, LAS VEGAS, NV 89118-1859
(469) 243-0164
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH03317
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2151229
PK
—
Enumeration date
03/04/2015
Last updated
01/23/2017
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