Provider Demographics
NPI:1841573094
Name:NGO, JANICE (RPH)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:NGO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7237 ADOBE HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-3040
Mailing Address - Country:US
Mailing Address - Phone:702-252-5004
Mailing Address - Fax:
Practice Address - Street 1:8582 BLUE DIAMOND RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89178-9202
Practice Address - Country:US
Practice Address - Phone:702-260-0135
Practice Address - Fax:702-260-7345
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14401183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist