MIRIAM FOMEN FANGA NPI 1063919991

NPI Information

Miriam Fomen Fanga is a community/retail pharmacy pharmacy in Las Vegas, NV. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. Miriam Fomen Fanga NPI is 1063919991. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4895 BOULDER HWY # 100
LAS VEGAS, NV
ZIP 89121-086
Phone: (702) 898-5264

The enumeration date for this NPI number is 4/8/2018 and was last updated on 6/16/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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