STATE OF NEVADA NPI 1417192980

NPI Information

  • NPI: 1417192980
  • Provider Name: STATE OF NEVADA
  • Classification: Pharmacy - 3336C0002X
  • Specialization: Clinic Pharmacy
  • Entity Type: Organization
  • Doing Business As: SOUTHERN NEVADA ADULT MENTAL HEALTH PHARMACY
  • Address: 1590 W SUNSET RD
    HENDERSON, NV
    ZIP 89014
  • Phone: (702) 486-6860

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NPI Details

STATE OF NEVADA is a clinic pharmacy pharmacy in Henderson, NV. The provider is a pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. STATE OF NEVADA NPI is 1417192980. The provider is registered as an organization entity type.
The provider Is Doing Business As Southern Nevada Adult Mental Health Pharmacy.

The provider's business location address is:

1590 W SUNSET RD
HENDERSON, NV
ZIP 89014-633
Phone: (702) 486-6860
Fax: (702) 486-6862

The provider's authorized official is Charles Costas .
The authorized official title is Statewide Pharmacy Director and has the following contact phone number (702) 486-6301.

The enumeration date for this NPI number is 12/11/2008 and was last updated on 7/13/2016.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0002XPharmacyClinic PharmacyPH01180NEVADAYes

Other Identifiers

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

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12052188OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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