Provider Demographics
NPI:1841786415
Name:LAS VEGAS SCRIPTS RX LLC.
Entity Type:Organization
Organization Name:LAS VEGAS SCRIPTS RX LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EDOUARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:702-832-3600
Mailing Address - Street 1:2920 N GREEN VALLEY PKWY STE 814
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-0409
Mailing Address - Country:US
Mailing Address - Phone:702-832-3600
Mailing Address - Fax:702-832-5733
Practice Address - Street 1:2920 N GREEN VALLEY PKWY STE 814
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014
Practice Address - Country:US
Practice Address - Phone:833-834-2779
Practice Address - Fax:833-834-2780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-07
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV19462333600000X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS48399OtherFLORIDA BOP PHARMACY REGISTRATION #
ARPD13983OtherARKANSAS - BOP PHARMACY REGISTRATION #
NVPH03930OtherNEVADA BOP PHARMACY REGISTRATION #