Organization
NICKAL INC
Active
Other names
Prospect Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMMY JON SHEEHAN RPH (OWNER)
(740) 494-2663
Entity
Organization
Contact information
Practice address
171 S. MAIN ST., PROSPECT, OH 43342
(740) 494-2663
(740) 494-4087
Mailing address
171 S MAIN ST, PO BOX 68, PROSPECT, OH 43342-9569
(740) 494-2663
(740) 494-4087
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
02069125004609
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0871169
—
OH
Enumeration date
11/20/2006
Last updated
01/24/2014
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