Provider Demographics
NPI:1487185005
Name:NEVADA HEALTH RX INC
Entity Type:Organization
Organization Name:NEVADA HEALTH RX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNDEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-343-0065
Mailing Address - Street 1:61 SPECTRUM BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-4838
Mailing Address - Country:US
Mailing Address - Phone:702-637-0817
Mailing Address - Fax:702-637-1358
Practice Address - Street 1:61 SPECTRUM BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-4838
Practice Address - Country:US
Practice Address - Phone:702-637-0817
Practice Address - Fax:702-637-1358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-24
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2168849OtherPK