MIRIAM FOMEN FANGA


Address: 4895 Boulder Hwy # 100, Las Vegas, NV 89121-3086
Phone: 7028985264

MIRIAM FOMEN FANGA (NPI# 1063919991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1063919991
Entity Type Individual
Full Name MIRIAM FOMEN FANGA
Practice Address 4895 Boulder Hwy # 100
Las Vegas
NV 89121-3086
Mailing Address 2180 E Warm Springs Rd Unit 2163
Las Vegas
NV 89119-0449
Practice Telephone 7028985264
Mailing Telephone 2404621809
Enumeration Date 2018-04-08
Last Update Date 2018-06-16
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 3336C0003X Pharmacy
Specialization: Community/Retail Pharmacy
19831 NV Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
NV PHARMACIST 19831 01

Office Location

Street Address 4895 BOULDER HWY # 100
City LAS VEGAS
State NV
Zip Code 89121-3086

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NPI Name Taxonomy Address Enumeration
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1962025155 Arieste Diaz Perez Clinic/Center 3777 Pecos-mcleod Interconnect, Suite 101, Las Vegas, NV 89121 2020-05-21
1366071904 Vanesa Silva Behavior Technician 4714 Flamigo Rd, Las Vegas, NV 89121 2020-04-06
1053955732 Valente Solis Santiago Technician 2785 E. Desert Inn Rd Ste. 240, Las Vegas, NV 89121 2019-11-05
1750938981 Ken Ernst Rehabilitation Practitioner Primary Solutions Medical Billing, 4525 S. Sandhill Rd Ste #112, Las Vegas, NV 89121 2019-08-22
1902450455 Tracey Anora Henry Counselor 3675 Pecos Mecleod Ste 900, Las Vegas, NV 89121 2019-08-01
1679127096 Wilma Guadalupe Nunez Chore Provider 2860 East Flamingo, Suite C, Las Vegas, NV 89121 2019-07-25
1487213807 Karla Susana Ayala Chore Provider 2860 E. Flamingo Rd Ste K., Las Vegas, NV 89121 2019-06-10
1447819164 Jovita Garcia-perez Chore Provider 2860 E. Flamingo Suite C, Suite C, Las Vegas, NV 89121 2019-06-06
1164081972 Maria Isabel Castellanos Gonzalez Chore Provider 2860 E. Flamingo Rd Ste K, Las Vegas, NV 89121 2019-06-06
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Taxonomy Information

Taxonomy Code 3336C0003X
Grouping Suppliers
Classification Pharmacy
Specialization Community/Retail Pharmacy

Taxonomy Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1205442928 Plus One Pharmacy, LLC Pharmacy 6545 S Fort Apache Rd Ste 140, Las Vegas, NV 89148-6758 2020-09-17
1790308880 Capsule Las Vegas LLC Pharmacy 801 S Rancho Dr Ste A4, Las Vegas, NV 89106-3870 2020-05-22
1417596511 Caremark L.L.C. Pharmacy 7251 S Eastern Ave, Las Vegas, NV 89119-4507 2020-01-06
1609411610 Credo Pharmacy LLC Pharmacy 8995 W Flamingo Rd Ste 120, Las Vegas, NV 89147-0441 2019-11-13
1629637129 Modern Rx Pharmacy 6330 S Eastern Ave Ste 1a, Las Vegas, NV 89119-3168 2019-06-07
1750947677 Southwest Specialty Pharmacy LLC Pharmacy 8170 S Eastern Ave Ste 10, Las Vegas, NV 89123-2578 2019-05-16
1447728373 Goodwill Pharmacy Inc Pharmacy 6725 S Eastern Ave Ste 7, Las Vegas, NV 89119-3949 2018-11-08
1699240697 Silver State Pharmacy LLC Pharmacy 1591 N Buffalo Dr Ste 140, Las Vegas, NV 89128-3632 2018-10-05
1275019770 Guadalupe Pharmacy Inc. Pharmacy 3827 E Sunset Rd Ste L, Las Vegas, NV 89120-3900 2018-07-17
1629569892 Sahara Limited Group LLC. Pharmacy 6125 W Sahara Ave Ste 1a, Las Vegas, NV 89146-3002 2018-05-23
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Competitor

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City LAS VEGAS
Zip Code 89121

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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