Provider Demographics
NPI:1013674316
Name:ROSE, JANICE (RPH)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:ROSE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2466 E DESERT INN RD STE C
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-3622
Mailing Address - Country:US
Mailing Address - Phone:702-737-1483
Mailing Address - Fax:702-792-8177
Practice Address - Street 1:2466 E DESERT INN RD STE C
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-3622
Practice Address - Country:US
Practice Address - Phone:702-737-1483
Practice Address - Fax:702-792-8177
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-21
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70183183500000X
TX323966183700000X
NV13727183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No183700000XPharmacy Service ProvidersPharmacy Technician