# NUCKOLLS DRUG STORES, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hudson Drug Store
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437160082
- **Authorized official:** JAMES KIM NUCKOLLS (PRES)
- **Authorized official phone:** (731) 658-5207

## Contact information

- **Practice address:** 600 NUCKOLLS RD, BOLIVAR, TN 38008-2393
- **Practice address phone:** (731) 658-5207
- **Practice address fax:** (731) 658-1758
- **Mailing address:** 600 NUCKOLLS RD, BOLIVAR, TN 38008-2393
- **Mailing address phone:** (731) 658-5207
- **Mailing address fax:** (731) 658-1758

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 128 | TN | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | — | — |

## Other

- **Enumeration date:** 08/10/2006
- **Last updated:** 12/11/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4401600 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |