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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