SONORAN PHARMACY GROUP INC (NPI# 1285908798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285908798 |
| Entity Type | Organization |
| Organization Name | SONORAN PHARMACY GROUP INC |
| Other Organization Name | WELLCARE LTC PHARMACY |
| Practice Address |
4101 Wagon Trail Ave Las Vegas NV 89118-4426 |
| Mailing Address |
1313 E Maple St Suite 210 Bellingham WA 98225-5708 |
| Practice Telephone | 7025769545 |
| Practice Fax Number | 7029460353 |
| Mailing Telephone | 3606854270 |
| Mailing Fax Number | 3602057504 |
| Enumeration Date | 2012-03-01 |
| Last Update Date | 2016-11-07 |
| Authorized Official Name | BLAIR WHITNEY (GREFFIER) |
| Authorized Official Telephone | 3605437376 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
PH02771 | NV | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2152490 | 01 |
| Other Name | Type Code |
|---|---|
| WellCare LTC Pharmacy | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | SONORAN PHARMACY GROUP INC. | 851 Coho Way Ste 312, Bellingham, WA 98225-2066 |
| Street Address |
4101 WAGON TRAIL AVE |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89118-4426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316920986 | Sean Daly Beaty | Radiology | 4101 Wagon Trail Ave, Las Vegas, NV 89118-4426 | 2005-11-28 |
| 1841709219 | Shree Sainath LLC | Pharmacy | 4101 Wagon Trail Ave, Las Vegas, NV 89118-4426 | 2017-09-28 |
| 1275083396 | Ashkan Mousavinasab | Pharmacist | 4101 Wagon Trail Ave, Las Vegas, NV 89118-4426 | 2016-10-12 |
| 1669553954 | Shao-pow Lin | Radiology | 4101 Wagon Trail Ave, Las Vegas, NV 89118-4426 | 2006-10-17 |
| 1982706974 | Sunil Kumar Gujrathi | Radiology | 4101 Wagon Trail Ave, Las Vegas, NV 89118-4426 | 2006-09-01 |
| 1861417792 | Varoujan Kostanian | Radiology | 4101 Wagon Trail Ave, Las Vegas, NV 89118-4426 | 2006-07-13 |
| 1508844713 | David P Gorczyca | Radiology | 4101 Wagon Trail Ave, Las Vegas, NV 89118-4426 | 2006-01-06 |
| 1336126721 | Aaron Thomas Peterson | Radiology | 4101 Wagon Trail Ave, Las Vegas, NV 89118-4426 | 2005-12-27 |
| 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 | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588273684 | Trinity Pharmacy LLC | Pharmacy | 2797 S Maryland Pkwy Ste 28, Las Vegas, NV 89109-1576 | 2020-07-24 |
| 1154796506 | Refill Pharmacy 1 LLC | Pharmacy | 8536 Del Webb Blvd, Las Vegas, NV 89134-8676 | 2015-12-10 |
| 1770886582 | Assist Care Pharmacy Inc. | Pharmacy | 3045 E. Post Rd, Las Vegas, NV 89120 | 2010-12-16 |
| 1245332055 | Omnicare of Nevada, LLC | Pharmacy | 1525 E Sunset Rd, Suite 16, Las Vegas, NV 89119-4911 | 2006-09-02 |
| 1922607837 | Buddy's Pharmacy LLC | Pharmacy | 3035 S. Maryland Parkway, Suite 120, Las Vegas, NV 89109 | 2020-10-21 |
| 1841709219 | Shree Sainath LLC | Pharmacy | 4101 Wagon Trail Ave, Las Vegas, NV 89118-4426 | 2017-09-28 |
| 1205388865 | Turquoise, Ltd. | Pharmacy | 602 University Ave, Las Vegas, NM 87701-4248 | 2016-10-31 |
| 1740583798 | Cofii Corporation | Pharmacy | 2202 W Charleston Blvd, #13, Las Vegas, NV 89102-2232 | 2010-12-14 |
| 1598966798 | State of New Mexico | Pharmacy | 3695 Hot Springs Blvd, Las Vegas, NM 87701-9549 | 2007-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023410313 | Abacusrx Pharmacy LLC | Pharmacy | 1516 W Warm Springs Rd, Henderson, NV 89014-4339 | 2014-09-18 |
| 1376960666 | Sierra Specialty Pharmacy LLC | Pharmacy | 9738 S Virginia St Ste F, Reno, NV 89511-4811 | 2014-03-25 |
| 1730220468 | Spectrum Pharmacy Services LLC | Pharmacy | 4690 Longley Lane, A-39, Reno, NV 89502 | 2007-02-08 |
| 1396847133 | Omnicare of Nevada, LLC | Pharmacy | 9475 Double R Blvd, Suite 8, Reno, NV 89521-8955 | 2006-09-02 |
| 1346261575 | Pharmerica Mountain LLC | Pharmacy | 3825 W Cheyenne Ave # 603, North Las Vegas, NV 89032-3408 | 2006-07-22 |
| 1275587867 | Flying Diamond Pharmacy LLC | Pharmacy | 6140 Mae Anne Ave Ste 1b, Reno, NV 89523-4707 | 2006-05-19 |
| 1518470707 | Economy Drug, Inc. | Pharmacy | 696 Aultman St, Ely, NV 89301-1555 | 2017-11-09 |
| 1760569776 | Battle Mountain General Hosp | Pharmacy | 535 S Humboldt St, Battle Mountain, NV 89820 | 2006-11-01 |
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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.