Provider Demographics
NPI:1760698070
Name:TORRICER, IMELDA (PHARMACIST)
Entity Type:Individual
Prefix:MISS
First Name:IMELDA
Middle Name:
Last Name:TORRICER
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:992 CLEAR DIAMOND AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-3687
Mailing Address - Country:US
Mailing Address - Phone:702-896-0405
Mailing Address - Fax:702-896-0405
Practice Address - Street 1:2995 E FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5214
Practice Address - Country:US
Practice Address - Phone:702-737-6164
Practice Address - Fax:702-737-6163
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14066183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist