Provider Demographics
NPI:1124657002
Name:PRECISION SPECIALTY PHARMACY CORP
Entity type:Organization
Organization Name:PRECISION SPECIALTY PHARMACY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAIORANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-575-2182
Mailing Address - Street 1:2775 S JONES BLVD STE 100A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5655
Mailing Address - Country:US
Mailing Address - Phone:702-405-9500
Mailing Address - Fax:702-405-9501
Practice Address - Street 1:2775 S JONES BLVD STE 100A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5655
Practice Address - Country:US
Practice Address - Phone:702-405-9500
Practice Address - Fax:702-405-9501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-03
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy