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FLYING DIAMOND PHARMACY LLC

Assisted Living, Behavioral Disturbances

Reno, Nevada

Provider NPI: 1275587867

Organization Information:
Organization Name:  FLYING DIAMOND PHARMACY LLC


Practice Location:
6140 MAE ANNE AVE STE 1B  RENO, NV 89523 US
Tel: 775-787-1144  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y3336L0003XSuppliers
Pharmacy
Long Term Care Pharmacy
NVPH02114

Other Provider Identifiers:

IssuerNumberStateType
100509084NV05
100509085NV05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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