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Contact Information

PHARMERICA MOUNTAIN LLC
3825 W CHEYENNE AVE # 603
NORTH LAS VEGAS, NV89032-3408
 Phone: 702-871-1920
 Fax: 702-871-4203
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PHARMERICA MOUNTAIN LLC

NPI Number 1346261575
LBN Legal business name PHARMERICA MOUNTAIN LLC
Authorized official ALLISON BROWN - (SECRETARY)
Entity Organization
Organization subpart 1 Yes
Enumeration date 07/22/2006
Last updated 02/13/2024 - About 2 years ago
Identifiers
NV License # PH01635
NV Medicaid 003702002
UT Medicaid 3000009
NV Other PHC01635 BOARD OF PHARMACY
UT Other 10562714-1708 BOARD OF PHARMACY
UT Other 11465757-1708 BOARD OF PHARMACY
UT Other 11465757-8913 BOARD OF PHARMACY
UT Other 10562714-8913 CONTROLLED SUBSTANCE
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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