Provider Demographics
NPI:1912042201
Name:FVS HOLDINGS INC
Entity Type:Organization
Organization Name:FVS HOLDINGS INC
Other - Org Name:NEVADA DRUG COMPOUNDING PHARMACY EAST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATION ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-564-2079
Mailing Address - Street 1:1850 WHITNEY MESA DR
Mailing Address - Street 2:STE 180
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-2091
Mailing Address - Country:US
Mailing Address - Phone:702-564-2079
Mailing Address - Fax:702-948-6820
Practice Address - Street 1:3041 W HORIZON RIDGE PKWY
Practice Address - Street 2:STE 100
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3948
Practice Address - Country:US
Practice Address - Phone:702-293-6900
Practice Address - Fax:702-293-0095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X, 3336S0011X
NVPH017133336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2900199OtherNCPDP PROVIDER IDENTIFICATION NUMBER