Provider Demographics
NPI:1740405463
Name:BIANCA, JAMES PETER (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PETER
Last Name:BIANCA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8975 W WARM SPRINGS RD APT 1123 BLDG 18
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-2893
Mailing Address - Country:US
Mailing Address - Phone:702-796-1955
Mailing Address - Fax:
Practice Address - Street 1:6225 ANNIE OAKLEY DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3914
Practice Address - Country:US
Practice Address - Phone:702-436-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV15008183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist