NEVADA CVS PHARMACY LLC NPI 1417993569

NPI Information

NPI: 1417993569
Provider Name: NEVADA CVS PHARMACY LLC
Classification: Pharmacy - 333600000X
Entity Type: Organization
Doing Business As: CVS PHARMACY # 08808
Address: 2011 E LAKE MEAD BLVD
NORTH LAS VEGAS, NV
ZIP 89030
Phone: (702) 649-1991

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NPI Details

NEVADA CVS PHARMACY LLC is a pharmacy in North Las Vegas, NV. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. NEVADA CVS PHARMACY LLC NPI is 1417993569. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy # 08808.

The provider's business location address is:

2011 E LAKE MEAD BLVD
NORTH LAS VEGAS, NV
ZIP 89030-135
Phone: (702) 649-1991

The provider's authorized official is Cristiana Mauricio .
The authorized official title is Manager Pharmacy Enrollments and has the following contact phone number (401) 770-2937.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

Administration of influenza virus vaccine (HCPCS:G0008)
Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
Fee covid-19 vac 13 res (HCPCS:0124A)
Influenza vaccine split virus, preservative free (HCPCS:90662)
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use (HCPCS:90677)

The enumeration date for this NPI number is 6/20/2006 and was last updated on 7/16/2021.

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
1	333600000X	Pharmacy				Yes
2	3336C0003X	Pharmacy	Community/Retail Pharmacy			No

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
1	2989501	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

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: 11/21/2025

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