Provider Demographics
NPI:1386287035
Name:MARKARIAN, SERJ SOUKAZ (PHARMD)
Entity type:Individual
Prefix:
First Name:SERJ
Middle Name:SOUKAZ
Last Name:MARKARIAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27362
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89126-1362
Mailing Address - Country:US
Mailing Address - Phone:818-618-2069
Mailing Address - Fax:
Practice Address - Street 1:1801 S DECATUR BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-8518
Practice Address - Country:US
Practice Address - Phone:818-618-2069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV16248183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist