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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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