Nevada Family Practice Residence Program

NPI #1083683874 in Las Vegas, Nevada

Provider Information

NPI Number
1083683874
Entity Type
Organization
Organization Name
Nevada Family Practice Residence Program
Primary Specialty
Pharmacy
Enumeration Date
Mar 15, 2006
Last Updated
Oct 5, 2010

Practice Location

Address
4000 E CHARLESTON BLVD
Address 2
B-130
State
Nevada
ZIP Code
89104-6659
Phone
(702) 968-4038

Authorized Official

Name
MR. KENNETH J. RYAN, RPH
Title
PHARMACIST/MANAGER
Phone
(702) 968-4038

Specialties & Taxonomy Codes

Specialty
Pharmacy

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