FIDELIS HEALTH GROUP LLC (NPI# 1255761128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255761128 |
| Entity Type | Organization |
| Organization Name | FIDELIS HEALTH GROUP LLC |
| Other Organization Name | FIDELIS SPECIALTY PHARMACY |
| Practice Address |
5275 Arville St Ste 156 Las Vegas NV 89118-4937 |
| Practice Telephone | 7028150800 |
| Practice Fax Number | 7028150801 |
| Mailing Telephone | 7028150800 |
| Mailing Fax Number | 7028150801 |
| Enumeration Date | 2013-11-13 |
| Last Update Date | 2018-09-20 |
| Authorized Official Name | WAGNER A LEMUS (PRESIDENT) |
| Authorized Official Telephone | 7028150800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PH03042 | NV | Suppliers |
| Y | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | 1255761128 | 05 |
| Other Name | Type Code |
|---|---|
| Fidelis Specialty Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316135569 | Fidelis Health Group LLC | Pharmacy | 1002 S Baldwin Ave, Arcadia, CA 91007-7234 | 2007-10-11 |
| Street Address |
5275 ARVILLE ST STE 156 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89118-4937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194946640 | Russell D. Lubrani | Pharmacist | 5275 Arville St Ste 156, Las Vegas, NV 89118-4937 | 2007-05-01 |
| 1740731587 | Zachary Bergan | Pharmacist | 5275 Arville St Ste 156, Las Vegas, NV 89118-4937 | 2016-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720568520 | Kurt Yaross | Behavioral Analyst | 7138 W Post Rd, #208, Las Vegas, NV 89118 | 2018-08-21 |
| 1619457108 | Michelle Herzberg | Behavioral Analyst | 7318 W Post Rd #280, Las Vegas, NV 89118 | 2018-08-15 |
| 1548749385 | Keisha Bere-ruiz | Behavioral Analyst | 7318 W Post Rd #208, Las Vegas, NV 89118 | 2018-08-13 |
| 1295222081 | Aliantcare | Radiologic Technologist | 5490 S Rainbow Blvd, Suite 400 N34835, Las Vegas, NV 89118 | 2018-04-17 |
| 1710406467 | Anoush H. Tacvorian Do LLC | Clinic/Center | 6525 W. Warm Springs Rd, Suite 100, Las Vegas, NV 89118 | 2017-09-13 |
| 1962920470 | Harvard Medtech, LLC | Durable Medical Equipment & Medical Supplies | 6280 S. Valley View Blvd, Suite 412, Las Vegas, NV 89118 | 2017-09-05 |
| 1750827903 | Kerry Cutler | Nurse Practitioner | 6020 South Rainbow Blvd, Suite C, Las Vegas, NV 89118 | 2017-01-12 |
| 1184173015 | Girisgen & Kopolow Od PC | Optometrist | 7090 S Rainbow Blvd, Ste 100, Las Veegas, NV 89118 | 2016-10-04 |
| 1396117859 | Foundation for Positively Kids | Clinic/Center | 3555 E Reno, Ste F, Las Vegas, NV 89118 | 2015-10-23 |
| 1720492663 | Kiet Michael Lam | Chiropractor | 5693 S. Jones Bvld, Ste 116, Las Vegas, NV 89118 | 2014-06-18 |
| Find all providers in zip 89118 | ||||
| Taxonomy Code | 3336S0011X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Specialty Pharmacy |
| A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration. |
| 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] |
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|---|---|---|---|---|
| 1922303692 | Option Care Enterprises, Inc | Pharmacy | 4708 W Sahara Ave, Las Vegas, NV 89102 | 2011-01-11 |
| 1487978136 | Fvs Holdins Inc | Pharmacy | 6370 W Flamingo Rd Ste 1, Las Vegas, NV 89103-2274 | 2010-03-24 |
| 1023242559 | Advanced Pharmacy Staffing | Pharmacy | 6295 Harrison Dr, Suite 3, Las Vegas, NV 89120-4045 | 2009-05-12 |
| 1801965017 | Apria Healthcare, Inc. | Pharmacy | 3955 W Mesa Vista Ave, Suite 1, Las Vegas, NV 89118-2338 | 2006-11-06 |
| 1720099369 | Tlgrx Corporation | Pharmacy | 8579 S Eastern Ave Ste B, Las Vegas, NV 89123-2887 | 2006-08-10 |
| 1396255949 | Level Care Pharmacy I LLC | Pharmacy | 212 Carpenters Union Way Ste 500, Las Vegas, NV 89119 | 2017-10-10 |
| 1568637783 | Spring Valley Pharmacy | Pharmacy | 2725 S Jones Blvd, Ste 101, Las Vegas, NV 89146-5667 | 2008-04-29 |
| 1306042841 | Children's Shoe World | Pharmacy | 1924 E Sahara Ave, Las Vegas, NV 89104-3843 | 2007-06-22 |
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|---|---|---|---|---|
| 1992173033 | Gtmi Corporation | Pharmacy | 1510 W Sunset Rd Ste 120, Henderson, NV 89014-2695 | 2015-09-07 |
| 1912205378 | Shoshone Paiute Tribes | Pharmacy | 1623 Hospital Loop, Owyhee, NV 89832-1200 | 2011-03-09 |
| 1952608812 | Guided Alliance Pharmacy Inc | Pharmacy | 7025 Longley Ln, Suite 30-a, Reno, NV 89511-1238 | 2011-02-11 |
| 1831683655 | Tango, Inc | Pharmacy | 4090 W Craig Rd Ste 101, North Las Vegas, NV 89032-2758 | 2018-06-15 |
| 1699183939 | Atlas Specialty Pharmacy | Pharmacy | 301 N Pecos Rd, Henderson, NV 89074-1349 | 2014-07-31 |
| 1063516425 | Arlington Aquisition I, Inc. | Pharmacy | 6630 S Mccarran Blvd, #14, Reno, NV 89509-6135 | 2006-09-07 |
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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.