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Organization
NICHOLLS PHARMACY LLC
Active
Organization
NICHOLLS PHARMACY LLC
Active
Other names
NICHOLLS PHARMACY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JAN SCOTT RPH (OWNER,PRES,PIC,AO)
(912) 345-1021
Entity
Organization
Contact information
Practice address
1003 VAN STREAT HWY, NICHOLLS, GA 31554-5031
(912) 345-1021
(912) 345-1023
Mailing address
PO BOX 247, NICHOLLS, GA 31554-0247
(912) 345-1021
(912) 345-1023
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009134
GA
Other
Enumeration date
03/19/2007
Last updated
09/17/2015
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