Organization
SOUTHWEST PHARMACY LLC
Active
Organization
SOUTHWEST PHARMACY LLC
Active
Other names
SOUTHWEST PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN TRAN RPH (OWNER, PIC, AO)
(702) 929-2229
Entity
Organization
Contact information
Practice address
4550 E BONANZA RD UNIT C, LAS VEGAS, NV 89110-6308
(702) 929-2229
(702) 929-2951
Mailing address
4550 E BONANZA RD UNIT C, LAS VEGAS, NV 89110-6308
(702) 929-2229
(702) 929-2951
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH03520
NV
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538529102
—
NV
01
—
2158270
PK
—
Enumeration date
02/25/2016
Last updated
04/27/2016
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