Organization
NIKI LLC
Active
Other names
HIGH ST DISCOUNT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KIRTAN PATEL (PRESIDENT)
(240) 448-3301
Entity
Organization
Contact information
Practice address
30 HIGH ST, WALDORF, MD 20602-1846
(201) 744-0481
(240) 448-3302
Mailing address
30 HIGH ST, WALDORF, MD 20602-1846
(240) 448-3301
(240) 448-3302
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
P06652
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2167763
PK
—
05
—
541065700
—
MD
Enumeration date
03/30/2017
Last updated
03/30/2017
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