NPI 1578055026 · live from the CMS NPI Registry
Peter Pons Bautista, PharmD, MBA
Pharmacy, Institutional Pharmacy in Las Vegas, NV. National Provider Identifier 1578055026, active.
NPI record
| NPI | 1578055026 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy, Institutional Pharmacy 3336I0012X |
| Practice location | 620 Shadow Ln, Pharmacy, Las Vegas, NV 89106 |
| Practice phone | 702-388-8479 |
| Mailing address | 620 Shadow Ln, Pharmacy Department - Pb, Las Vegas, NV 89106 |
| Enumerated | May 31, 2018 |
| Last updated | May 31, 2018 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacy, Institutional Pharmacy primary | 3336I0012X | 19662 (NV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.