NEVADA FAMILY PRACTICE RESIDENCE PROGRAM (NPI# 1083683874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083683874 |
| Entity Type | Organization |
| Organization Name | NEVADA FAMILY PRACTICE RESIDENCE PROGRAM |
| Other Organization Name | CAMPUS PHARMACY III |
| Practice Address |
4000 E Charleston Blvd B-130 Las Vegas NV 89104-6659 |
| Practice Telephone | 7029684038 |
| Practice Fax Number | 7029684033 |
| Mailing Telephone | 7029684038 |
| Mailing Fax Number | 7029684033 |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2010-10-05 |
| Authorized Official Name | MR. KENNETH J. RYAN (PHARMACIST/MANAGER) |
| Authorized Official Telephone | 7029684038 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | PH1189 | NV | Suppliers |
| Other Name | Type Code |
|---|---|
| Campus Pharmacy III | Other Name - Individual/Organization |
| Street Address |
4000 E CHARLESTON BLVD B-130 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89104-6659 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598207847 | Delores Glenn-lewis | Counselor | 4000 E Charleston Blvd, 226, Las Vegas, NV 89104-6659 | 2016-11-17 |
| 1447602974 | Dori Hilson | Social Worker | 4000 E Charleston Blvd, Las Vegas, NV 89104-6659 | 2016-07-08 |
| 1386096766 | Alexis Harris | Community Health Worker | 4000 E Charleston Blvd, Ste. 230, Las Vegas, NV 89104-6659 | 2016-07-08 |
| 1770930133 | Erin Maria Spanberger | Counselor | 4000 E Charleston Blvd, Suite #230, Las Vegas, NV 89104-6659 | 2016-05-16 |
| 1447619267 | Brandi Mcconnell | Social Worker | 4000 E Charleston Blvd, Suite 230, Las Vegas, NV 89104-6659 | 2016-02-22 |
| 1548639271 | Desirae Chantal Murenzi | Registered Nurse | 4000 E Charleston Blvd, Sutie 230, Las Vegas, NV 89104-6659 | 2015-09-23 |
| 1518335801 | Angela Acuna | Registered Nurse | 4000 E Charleston Blvd, Suite 230, Las Vegas, NV 89104-6659 | 2015-09-03 |
| 1053795898 | Natalie Rose Schmaltz | Social Worker | 4000 E Charleston Blvd, 230, Las Vegas, NV 89104-6659 | 2015-07-10 |
| 1124456033 | Winnie Wegner | Registered Nurse | 4000 E Charleston Blvd, Ste #130, Las Vegas, NV 89104-6659 | 2013-10-31 |
| 1972941854 | William Manuel Velez | Social Worker | 4000 E Charleston Blvd, Suite 230, Las Vegas, NV 89104-6659 | 2013-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316550635 | Comfort Care Senior Services LLC | In Home Supportive Care | 1601 S Sandhill Rd, 62, Las Vegas, NV 89104 | 2020-08-26 |
| 1508484734 | Accessible Space Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1405 South Mojave Rd, Las Vegas, NV 89104 | 2020-07-14 |
| 1003448333 | Shirley Lauren Valenzona-gianan | Pharmacist | Smith's Pharmacy #318, 4965 East Sahara Avenue, Las Vegas, NV 89104 | 2020-02-05 |
| 1427602713 | Alma Lucia Lozano-vargas | Chore Provider | 1785 E. Sahara Ave. Suite 485, Las Vegas, NV 89104 | 2019-07-25 |
| 1396398947 | Martinez Antuan Coates | Psychologist | 1755 Palm St Bld T Apt147, Las Vegas, NV 89104 | 2019-07-23 |
| 1982171518 | Ian Sande | Occupational Therapist | 1500 West Warm Springs Rd, Las Vegas, NV 89104 | 2018-11-01 |
| 1215436563 | A Better Life In Home Care, LLC | Technician | 1810 East Sahara Avenue, Suite 216, Las Vegas, NV 89104 | 2018-02-01 |
| 1891202016 | Nevada Helping Hands LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1810 E Sahara Ave Ste 143, Las Vegas, NV 89104 | 2018-01-09 |
| 1760901581 | Fannie Bell | Counselor | 1800 E. Sahara Suite 104, Las Vegas, NV 89104 | 2017-09-13 |
| 1386162147 | Jaclyn Mustachio | Social Worker | 1860 E Sahara Ave, Las Vegas, NV 89104 | 2017-08-31 |
| Find all providers in zip 89104 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467085381 | Cmh Pharmacy LLC | Pharmacy | 6445 W Sunset Rd Ste 168, Las Vegas, NV 89118-3321 | 2020-02-19 |
| 1033740691 | Evergreen Pharmacy Inc | Pharmacy | 4110 S Maryland Pkwy Ste 17, Las Vegas, NV 89119-7505 | 2020-01-31 |
| 1134765837 | Scriptdash Inc | Pharmacy | 600 Pilot Rd Ste A, Las Vegas, NV 89119-9011 | 2019-11-18 |
| 1124678453 | Kcklg LLC | Pharmacy | 6496 Medical Center St Ste 101, Las Vegas, NV 89148-2409 | 2019-09-18 |
| 1417504382 | Eglc LLC | Pharmacy | 6725 S Eastern Ave Ste 8, Las Vegas, NV 89119-3949 | 2019-08-24 |
| 1023671518 | Jay Mataji Inc | Pharmacy | 2202 W Charleston Blvd Ste 13, Las Vegas, NV 89102-2229 | 2019-04-19 |
| 1609439280 | Central Rx Services, LLC | Pharmacy | 1451 Center Crossing Rd, Las Vegas, NV 89144-7047 | 2019-04-18 |
| 1093202046 | Benzene Khemikals | Pharmacy | 3050 E Bonanza Rd Ste 160, Las Vegas, NV 89101-3707 | 2018-04-16 |
| 1164924197 | Aeva II LLC | Pharmacy | 4641 Blue Diamond Rd Ste 120b, Las Vegas, NV 89139-7610 | 2018-03-06 |
| 1205347234 | Sunrise Pharmacy LLC | Pharmacy | 2560 E Sunset Rd Ste 102, Las Vegas, NV 89120-3517 | 2017-10-17 |
| Find all providers in LAS VEGAS | ||||
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| 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.