Organization
DIAMOND SPECIALTY PHARMACY LLC
Active
Organization
DIAMOND SPECIALTY PHARMACY LLC
Active
Other names
Diamond Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EARLMATTHEW PEREGRINO PHARMD (PHARMACIST IN CHARGE)
(702) 992-3668
Entity
Organization
Contact information
Practice address
4845 S FORT APACHE RD STE A, LAS VEGAS, NV 89147-7956
(702) 992-3668
(702) 665-4790
Mailing address
4845 S FORT APACHE RD STE A, LAS VEGAS, NV 89147-7956
(702) 992-3668
(702) 665-4790
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250034468
—
NV
Enumeration date
09/17/2024
Last updated
10/24/2024
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