Nicholls Pharmacy Llc
LBN: Nicholls Pharmacy Llc
Nicholls Pharmacy Llc is an health care organization with primary practice located at 1003 Van Streat Hwy , Nicholls GA 31554-5031. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Nicholls Pharmacy Llc can be contacted via phone (912) 345-1021, or through Scott, Jan via phone (912) 345-1021.
Contact Information
Primary practice address
1003 Van Streat Hwy
Nicholls GA 31554-5031
Phone: (912) 345-1021
Fax: (912) 345-1023
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PHRE009134 | Georgia |
Profile Details
| NPI number | 1184748808 |
|---|---|
| LBN Legal business name | Nicholls Pharmacy Llc |
| DBA Doing business as | Nicholls Pharmacy Llc |
| Authorized official | Scott, Jan RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 19th, 2007 |
| Last updated | Sep 17th, 2015 - about 11 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184748808 | NPPES |
| Georgia | MEDICAID | 569772164A | |
| Georgia | Other | 2016489 |
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