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Contact Information

PETER P BAUTISTA, PHARMD, MBA
620 SHADOW LN
PHARMACY
LAS VEGAS, NV89106-4194
 Phone: 702-388-8479
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Institutional Pharmacy

3336I0012X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PETER P BAUTISTA · (Male)

NPI Number 1578055026
Status Active
Credentials PHARMD, MBA
Entity Individual
Enumeration date 05/31/2018
Last updated 05/31/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • NV License # 19662
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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