Organization
SPECTRUM PHARMACY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN A LARIVIERE (CHIEF COMPLIANCE OFFICER)
(502) 627-7404
Entity
Organization
Contact information
Practice address
4690 LONGLEY LN # A-39, RENO, NV 89502-5954
(775) 825-6111
(775) 825-3840
Mailing address
1901 CAMPUS PL, LOUISVILLE, KY 40299-2308
(502) 627-7962
(855) 217-7498
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH01845
PHARMACY
NV
Enumeration date
12/16/2018
Last updated
11/18/2019
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