Provider Demographics
NPI:1053769703
Name:QHR PHARMACY 1, LLC
Entity type:Organization
Organization Name:QHR PHARMACY 1, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OFFICER / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOLIH
Authorized Official - Middle Name:OJONG
Authorized Official - Last Name:OROCK
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:702-331-6388
Mailing Address - Street 1:765 N NELLIS BLVD STE 7
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-5391
Mailing Address - Country:US
Mailing Address - Phone:702-331-6388
Mailing Address - Fax:702-331-7791
Practice Address - Street 1:765 N NELLIS BLVD STE 7
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-5391
Practice Address - Country:US
Practice Address - Phone:702-331-6388
Practice Address - Fax:702-331-7791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-02
Last Update Date:2022-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPH035633336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy