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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