Organization
FVS HOLDINS INC
Active
Other names
Nevada Drug Compounding Pharmacy - West
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN TRUITT (SENIOR VP)
(702) 564-2079
Entity
Organization
Contact information
Practice address
6370 W FLAMINGO RD STE 1, LAS VEGAS, NV 89103-2274
(702) 365-6100
Mailing address
6370 W FLAMINGO RD STE 1, LAS VEGAS, NV 89103-2274
(702) 365-6100
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
PH02596
NV
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2992306
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/24/2010
Last updated
05/06/2010
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