Organization
BAM HEALTHCARE LVIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN WIDROFF (OPERATIONS MANAGER)
(646) 732-1818
Entity
Organization
Contact information
Practice address
8930 W SUNSET RD STE 100, LAS VEGAS, NV 89148-5009
(702) 747-3007
(702) 747-3163
Mailing address
8930 W SUNSET RD STE 100, LAS VEGAS, NV 89148-5009
(702) 747-3007
(702) 747-3163
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH04062
BOP NEVADA
NV
Enumeration date
06/13/2019
Last updated
03/07/2023
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