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Organization
NUCKOLLS DRUG STORES, INC
Active
Organization
NUCKOLLS DRUG STORES, INC
Active
Other names
Hudson Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES KIM NUCKOLLS (PRES)
(731) 658-5207
Entity
Organization
Contact information
Practice address
600 NUCKOLLS RD, BOLIVAR, TN 38008-2393
(731) 658-5207
(731) 658-1758
Mailing address
600 NUCKOLLS RD, BOLIVAR, TN 38008-2393
(731) 658-5207
(731) 658-1758
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
128
TN
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4401600
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/10/2006
Last updated
12/11/2012
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