Provider Demographics
NPI:1114687928
Name:KOVASH-CASTRO, FAYE (RPH)
Entity Type:Individual
Prefix:
First Name:FAYE
Middle Name:
Last Name:KOVASH-CASTRO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9851 W CHARLESTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7516
Mailing Address - Country:US
Mailing Address - Phone:702-946-1204
Mailing Address - Fax:702-946-1208
Practice Address - Street 1:9851 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-7516
Practice Address - Country:US
Practice Address - Phone:702-946-1204
Practice Address - Fax:702-946-1208
Is Sole Proprietor?:No
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11124183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist