Provider Demographics
NPI:1861741837
Name:W CARE LLC
Entity type:Organization
Organization Name:W CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHCY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-538-9388
Mailing Address - Street 1:4845 S RAINBOW BLVD
Mailing Address - Street 2:STE 403
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-4916
Mailing Address - Country:US
Mailing Address - Phone:702-538-9388
Mailing Address - Fax:702-776-8982
Practice Address - Street 1:4845 S RAINBOW BLVD STE 403
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-4750
Practice Address - Country:US
Practice Address - Phone:702-538-9388
Practice Address - Fax:702-776-8982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-05
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336H0001X, 333600000X, 3336C0004X, 3336S0011X
NVPHC028553336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1861741837Medicaid
2136783OtherPK
2136783OtherPK