Provider Demographics
NPI:1205228731
Name:FIRST CLASS RX PHARMACY LLC
Entity Type:Organization
Organization Name:FIRST CLASS RX PHARMACY LLC
Other - Org Name:FIRST CLASS RX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-534-0325
Mailing Address - Street 1:3783 E DESERT INN RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-3338
Mailing Address - Country:US
Mailing Address - Phone:702-534-0325
Mailing Address - Fax:702-534-0336
Practice Address - Street 1:3783 E DESERT INN RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-3338
Practice Address - Country:US
Practice Address - Phone:702-534-0325
Practice Address - Fax:702-534-0336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-20
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPH033103336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2150374OtherPK