Organization
NELLIS CARE PHARMACY INC
Active
Organization
NELLIS CARE PHARMACY INC
Active
Other names
NELLIS CARE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHN SHERAFAT (MANAGER/OWNER)
(702) 272-2874
Entity
Organization
Contact information
Practice address
348 N NELLIS BLVD, LAS VEGAS, NV 89110-0053
(702) 531-6523
(702) 531-6524
Mailing address
316 MOUNT HOPE ST, HENDERSON, NV 89014-7853
(702) 531-6523
(702) 531-6524
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH02838
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10052733
—
NV
05
—
1316212194
—
NV
01
—
2134367
PK
—
Enumeration date
03/13/2012
Last updated
06/21/2016
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