Organization
VESPER SPECIALTY PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA KOROGHLI RPH (OWNER, PIC, AO)
(702) 335-9601
Entity
Organization
Contact information
Practice address
4225 S EASTERN AVE STE 16, LAS VEGAS, NV 89119-5485
(702) 333-4377
(702) 333-0998
Mailing address
4225 S EASTERN AVE STE 16, LAS VEGAS, NV 89119-5485
(702) 333-4377
(702) 333-0998
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH03671
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2168129
PK
—
Enumeration date
12/20/2016
Last updated
03/17/2017
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