Provider Demographics
NPI:1609651942
Name:QUALITY COMPOUNDING RX OF AMERICA
Entity Type:Organization
Organization Name:QUALITY COMPOUNDING RX OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUBDATUL
Authorized Official - Middle Name:
Authorized Official - Last Name:AREFIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:702-984-6640
Mailing Address - Street 1:801 S RANCHO DR STE E7
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-3812
Mailing Address - Country:US
Mailing Address - Phone:702-984-6640
Mailing Address - Fax:702-202-3420
Practice Address - Street 1:801 S RANCHO DR STE E7
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-3812
Practice Address - Country:US
Practice Address - Phone:702-984-6640
Practice Address - Fax:702-202-3420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy