Provider Demographics
NPI:1114701463
Name:ARRIOLA, MARY ROSE ISORENA (RPH)
Entity Type:Individual
Prefix:DR
First Name:MARY ROSE
Middle Name:ISORENA
Last Name:ARRIOLA
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 1:6222 MEADOWGRASS LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-1119
Mailing Address - Country:US
Mailing Address - Phone:702-815-9660
Mailing Address - Fax:
Practice Address - Street 1:6222 MEADOWGRASS LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-1119
Practice Address - Country:US
Practice Address - Phone:702-815-9660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV15919183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist