Organization
ADVANCED CARE RX PHARMACY 2 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EGHOMWARE JERRY IGBINOVIA (MANAGING OFFICER)
(702) 595-6265
Entity
Organization
Contact information
Practice address
4161 S EASTERN AVE, A-3, LAS VEGAS, NV 89119-5484
(702) 331-0284
(702) 331-0291
Mailing address
4161 S EASTERN AVE, A-3, LAS VEGAS, NV 89119-5484
(702) 331-0284
(702) 331-0291
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
02/16/2011
Last updated
02/16/2011
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