IndividualActive
Peter Bautista, PHARMD, MBA
NPI 1578055026 · Institutional Pharmacy · Las Vegas, NV
Provider details
- NPI number
- 1578055026
- Entity type
- Individual
- Primary specialty
- Institutional PharmacySuppliers
- Credential
- PHARMD, MBA
- Sex
- Male
- Sole proprietor
- Yes
- License
- 19662 (NV)
Specialties & taxonomies
Suppliers
Practice location
620 Shadow Ln
Pharmacy
Las Vegas, NV 89106-4194
Phone: (702) 388-8479
Approximate (ZIP-level) locationGet directions
Mailing address
620 Shadow Ln
Las Vegas, NV 89106-4194
Registry dates
- Enumerated
- 2018-05-31
- Last updated
- 2018-05-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.