Basic Information
| Provider Information | |||||||||
| NPI: | 1821040882 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PILLAI | ||||||||
| FirstName: | JEYACHANDRAN | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | M.S (PHARM) | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1363 VOLTURNO DR | ||||||||
| Address2: | |||||||||
| City: | HENDERSON | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89052 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028987670 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4700 NORTH LAS VEGAS BLVD | ||||||||
| Address2: | MIKE O'CALLAHAN HOSPITAL | ||||||||
| City: | NELLIS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89191 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7026533212 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 13865 | NV | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.