JIRATCHAYA SURIYACHOTTAKUL (NPI# 1881205623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881205623 |
| Entity Type | Individual |
| Full Name | JIRATCHAYA SURIYACHOTTAKUL |
| Practice Address |
6855 Aliante Pkwy North Las Vegas NV 89084-3195 |
| Mailing Address |
4185 Mango Tree Ct Las Vegas NV 89115-4125 |
| Practice Telephone | 7026426062 |
| Mailing Telephone | 7028352449 |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2020-08-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
20611 | NV | Pharmacy Service Providers |
| Street Address |
6855 ALIANTE PKWY |
| City | NORTH LAS VEGAS |
| State | NV |
| Zip Code | 89084-3195 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417023359 | Smiths Food & Drug Centers Inc | Durable Medical Equipment & Medical Supplies | 6855 Aliante Pkwy, North Las Vegas, NV 89084-3195 | 2006-11-24 |
| 1023648979 | Myrien Fernandez | Pharmacist | 6855 Aliante Pkwy, North Las Vegas, NV 89084-3195 | 2020-01-20 |
| 1932749231 | Matthew Kikuchi | Pharmacist | 6855 Aliante Pkwy, North Las Vegas, NV 89084-3195 | 2020-01-14 |
| 1437495512 | Chirag M Mehta | Pharmacist | 6855 Aliante Pkwy, North Las Vegas, NV 89084-3195 | 2012-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275016677 | Donna Faye Bonner | Technician | 121 Elks Peak Ave., 121 Elks Peak Ave, N. Las Vegas, NV 89084 | 2018-09-11 |
| 1376047662 | Dolly Leticia Diaz | Technician | 7133 Weavers Pl, North Las Vegas, NV 89084 | 2018-03-21 |
| 1649771841 | May Ruth Byrd | Chore Provider | 6638 Cinnabar Coast Lane, Las Vegas, NV 89084 | 2018-02-22 |
| 1841718541 | Tori Tobin | Occupational Therapist | 2550 Nature Park Drive, Ste. 180, North Las Vegas, NV 89084 | 2017-09-01 |
| 1568989986 | Necole Ealy | Day Training/Habilitation Specialist | 6905 Auklet Ln, N Las Vegas, NV 89084 | 2017-08-25 |
| 1871031906 | Mvp Primary Care LLC | Registered Nurse | 6935-104 Aliante Parkway, #509, North Las Vegas, NV 89084 | 2017-02-09 |
| 1679932743 | Melissa Brown | Occupational Therapist | 29 Chastain Park Drive, North Las Vegas, NV 89084 | 2016-02-18 |
| 1598163636 | Taylor Briana Mitchell | Behavioral Analyst | 6929 Puetollano Drive, North Las Vegas, NV 89084 | 2014-12-05 |
| 1801229240 | Faith Thomas | Behavioral Analyst | 634 W Lava Beds Wy, North Las Vegas, NV 89084 | 2013-08-20 |
| 1497028401 | Cornell Williams | Rehabilitation Practitioner | 6616 Lavender Lilly Ln #1, N. Las Vegas, NV 89084 | 2012-02-22 |
| Find all providers in zip 89084 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083231906 | Betsey Bergquist | Pharmacist | 4040 Martin Luther King Blvd, Ste B, North Las Vegas, NV 89032 | 2020-06-26 |
| 1275037897 | Wesley Vo | Pharmacist | 6715 Maple Mesa St, North Las Vegas, NV 89084-1220 | 2018-03-20 |
| 1205948569 | Chi Leung Chan | Pharmacist | 1237 W Alexander Rd, Apt 102, North Las Vegas, NV 89032-9081 | 2006-08-31 |
| 1215988506 | Michael John Tunney | Pharmacist | 1841 E Craig Rd, North Las Vegas, NV 89030-3391 | 2006-05-12 |
| 1093718991 | Meeta Patel | Pharmacist | 6900 Pecos Rd, North Las Vegas, NV 89086-4400 | 2005-05-24 |
| 1023648979 | Myrien Fernandez | Pharmacist | 6855 Aliante Pkwy, North Las Vegas, NV 89084-3195 | 2020-01-20 |
| 1992335996 | Robyn Elizabeth Cluck | Pharmacist | 2255 E Centennial Pkwy, North Las Vegas, NV 89081-5601 | 2020-01-19 |
| 1528698735 | Shenekeia Miles | Pharmacist | 4700 W Ann Rd, North Las Vegas, NV 89031-3463 | 2020-01-16 |
| 1396375457 | Andrew Carapucci | Pharmacist | 2255 Las Vegas Blvd N, North Las Vegas, NV 89030-5840 | 2020-01-16 |
| 1932749231 | Matthew Kikuchi | Pharmacist | 6855 Aliante Pkwy, North Las Vegas, NV 89084-3195 | 2020-01-14 |
| Find all providers in NORTH LAS VEGAS | ||||
| City | NORTH LAS VEGAS |
| Zip Code | 89084 |
Please comment or provide details below to improve the information on JIRATCHAYA SURIYACHOTTAKUL.
| 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.