Provider Demographics
NPI:1932635844
Name:OPTUMRX PHARMACY OF NEVADA, INC
Entity Type:Organization
Organization Name:OPTUMRX PHARMACY OF NEVADA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:BURR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-310-4701
Mailing Address - Street 1:650 N. NELLIS BOULEVARD
Mailing Address - Street 2:ATTN: MATTHEW DAVID HENDERSON
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-5382
Mailing Address - Country:US
Mailing Address - Phone:702-963-9400
Mailing Address - Fax:702-963-9401
Practice Address - Street 1:650 N. NELLIS BOULEVARD
Practice Address - Street 2:ATTN: MATTHEW DAVID HENDERSON
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-5382
Practice Address - Country:US
Practice Address - Phone:702-963-9400
Practice Address - Fax:702-963-9401
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATAMARAN HEALTH SOLUTIONS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-11
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy