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Contact Information

FLYING DIAMOND PHARMACY LLC
6140 MAE ANNE AVE STE 1B
RENO, NV89523-4707
 Phone: 775-787-1144
 Fax: 775-787-1143
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for FLYING DIAMOND PHARMACY LLC

NPI Number 1174578124
LBN Legal business name FLYING DIAMOND PHARMACY LLC
Authorized official TAMARA AVERA - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/24/2006
Last updated 05/12/2025 - More than a year ago
Identifiers
NV License # PH02114
NV Medicaid 1174578124
NV Medicaid 1275587867
Other 2052136 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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