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Individual

PETER PONS BAUTISTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD, MBA

Contact information

Practice address
620 SHADOW LN, PHARMACY, LAS VEGAS, NV 89106-4194
(702) 388-8479
Mailing address
620 SHADOW LN, PHARMACY DEPARTMENT - PB, LAS VEGAS, NV 89106-4194
(702) 388-8479

Taxonomy

Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
19662
NV

Other

Enumeration date
05/31/2018
Last updated
05/31/2018
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