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Organization

ADVANCED CARE RX PHARMACY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EGHE JERRY IGBINOVIA PHARM. D (OWNER)
(702) 595-6265
Entity
Organization

Contact information

Practice address
840 E TWAIN AVE STE 137, LAS VEGAS, NV 89169-4025
(702) 272-2709
(702) 405-0673
Mailing address
840 E TWAIN AVE STE 137, LAS VEGAS, NV 89169-4025
(702) 272-2709
(702) 405-0673

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH02583
NV
3336C0004X
Compounding Pharmacy
PH02583
NV

Other

Enumeration date
01/23/2010
Last updated
01/23/2010
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