Organization
UHS RETAIL PHARMACY LLC
Active
Other names
CentRx Pharmacy Centennial Hills
Organization subpart
No
Provider details
NPI number
Authorized official
MARVIN PEMBER BSC PHARMACY (CEO)
(610) 302-3300
Entity
Organization
Contact information
Practice address
6850 N DURANGO DR STE 108, LAS VEGAS, NV 89149-4596
(702) 470-2694
(214) 451-6110
Mailing address
6850 N DURANGO DR STE 108, LAS VEGAS, NV 89149-4596
(702) 470-2694
(214) 451-6110
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH03289
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2150423
PK
—
Enumeration date
02/12/2015
Last updated
01/23/2017
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