Provider Demographics
NPI:1982341475
Name:COMPLETE CARE PHARMACY & MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:COMPLETE CARE PHARMACY & MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:OGDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-604-6052
Mailing Address - Street 1:1090 E DESERT INN
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1090 E DESERT INN RD # 204
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2824
Practice Address - Country:US
Practice Address - Phone:702-983-2243
Practice Address - Fax:725-210-0337
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPLETE CARE PHARMACY & MEDICAL SUPPLY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy