Provider Demographics
NPI:1275398414
Name:CAPITAL CARE PHARMACY LLC
Entity Type:Organization
Organization Name:CAPITAL CARE PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-844-8445
Mailing Address - Street 1:5693 S JONES BLVD STE 119
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-1967
Mailing Address - Country:US
Mailing Address - Phone:702-844-8445
Mailing Address - Fax:702-780-5990
Practice Address - Street 1:5693 S JONES BLVD STE 119
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-1967
Practice Address - Country:US
Practice Address - Phone:702-844-8445
Practice Address - Fax:702-780-5990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy