Provider Demographics
NPI:1316531700
Name:MONICOS PHARMACY LLC
Entity type:Organization
Organization Name:MONICOS PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-505-4898
Mailing Address - Street 1:2701 N TENAYA WAY STE 120
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0479
Mailing Address - Country:US
Mailing Address - Phone:702-505-4898
Mailing Address - Fax:702-505-4899
Practice Address - Street 1:2701 N TENAYA WAY STE 120
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0479
Practice Address - Country:US
Practice Address - Phone:702-505-4898
Practice Address - Fax:702-505-4899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-25
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVPH04309OtherNEVADA BOARD OF PHARMACY