Organization
PMKM LLC
Active
Other names
Quality Home Infusion
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP MONTANO (OWNER)
(818) 848-8112
Entity
Organization
Contact information
Practice address
801 S RANCHO DR # 7, LAS VEGAS, NV 89106-3854
(702) 478-5133
(702) 478-5401
Mailing address
801 S RANCHO DR # 7, LAS VEGAS, NV 89106-3854
(702) 478-5133
(702) 478-5401
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
PHC02986
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326488784
—
NV
01
—
2140971
PK
—
Enumeration date
07/01/2013
Last updated
11/29/2016
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