Organization
PROCARE PHARMACY LLC
Active
Other names
Procare Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
THAI VO (OWNER/PRESIDENT)
(702) 426-6414
Entity
Organization
Contact information
Practice address
6870 S RAINBOW BLVD, SUITE 106, LAS VEGAS, NV 89118-2106
(702) 207-7777
(702) 207-0644
Mailing address
6870 S RAINBOW BLVD, SUITE 106, LAS VEGAS, NV 89118-2106
(702) 207-7777
(702) 207-0644
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH02774
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2992887
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/20/2012
Last updated
03/29/2012
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