Provider Demographics
NPI:1982341475
Name:COMPLETE CARE PHARMACY & MEDICAL SUPPLY INC
Entity type:Organization
Organization Name:COMPLETE CARE PHARMACY & MEDICAL SUPPLY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTRACTING & LICENSING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-983-2243
Mailing Address - Street 1:2080 E FLAMINGO RD STE 302
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5180
Mailing Address - Country:US
Mailing Address - Phone:702-983-2243
Mailing Address - Fax:725-550-8444
Practice Address - Street 1:2080 E FLAMINGO RD STE 302
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5180
Practice Address - Country:US
Practice Address - Phone:702-983-2243
Practice Address - Fax:725-550-8444
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPLETE CARE PHARMACY & MEDICAL SUPPLY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-16
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy