Organization
CENTERWELL PHARMACY, INC.
Active
Other names
Humana Pharmacy, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN LYSINGER (VP)
(502) 580-2376
Entity
Organization
Contact information
Practice address
1000 S RAINBOW BLVD, LAS VEGAS, NV 89145-6231
(702) 854-7812
(702) 259-2404
Mailing address
1000 S RAINBOW BLVD, LAS VEGAS, NV 89145-6231
(702) 854-7812
(702) 259-2404
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PH03608
NV
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2164075
PK
—
Enumeration date
09/12/2016
Last updated
02/24/2026
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