NICHOLLS PHARMACY (NPI# 1457460198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457460198 |
| Entity Type | Organization |
| Organization Name | NICHOLLS PHARMACY |
| Practice Address |
1003 Van Streat Hwy Nicholls GA 31554 |
| Mailing Address |
1003 Van Streat Hwy Po Box 247 Nicholls GA 31554 |
| Practice Telephone | 9123452444 |
| Mailing Telephone | 9123452444 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | BRAD W MOBLEY (OWNER/PHARMACIST) |
| Authorized Official Telephone | 9123452444 |
| Authorized Official Credential | REG PHARMACIST |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | PHRE006030 | GA | Pharmacy Service Providers |
| Street Address |
1003 VAN STREAT HWY |
| City | NICHOLLS |
| State | GA |
| Zip Code | 31554 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184748808 | Nicholls Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1003 Van Streat Hwy, Nicholls, GA 31554-5031 | 2007-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295095925 | Crh Physician Practices LLC | Clinic/Center | 804 N Liberty St, Nicholls, GA 31554 | 2012-05-29 |
| 1083846554 | Ashley Miller | Dentist | 1153 N Liberty St, Nicholls, GA 31554 | 2009-08-18 |
| 1508913278 | Sheila Lynette Taylor | Contractor | 117 Aspen Road, Nicholls, GA 31554 | 2007-01-04 |
| 1174639959 | Brad M Mobley | Pharmacist | 1003 Van Streat Highway, Nicholls, GA 31554 | 2006-08-22 |
| 1558898882 | Bacon County Health Services, Inc. | General Acute Care Hospital | 1205 Van Streat Hwy, Nicholls, GA 31554 | 2017-05-17 |
| 1760817795 | Healthstat On-site Clinic/milliken Alma | Preventive Medicine | 2410 Ga Highway 32 W, Nicholls, GA 31554-3446 | 2013-09-10 |
| 1922161033 | Myra Sellers | Speech-Language Pathologist | 105 Cherrywood Dr, Nicholls, GA 31554-3505 | 2006-12-19 |
| 1669418711 | Nicholls Clinic | Public Health or Welfare | 806 N Liberty St, Nicholls, GA 31554-4006 | 2006-06-20 |
| 1831568724 | Latasha Nicole Gilliard | Nurse Practitioner | 7171 Nails Rd, Nicholls, GA 31554-4613 | 2015-09-21 |
| 1285677872 | Pamela C. Lee | Nurse Practitioner | 1205 Van Streat Hwy, Nicholls, GA 31554-5025 | 2006-06-13 |
| Find all providers in zip 31554 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174639959 | Brad M Mobley | Pharmacist | 1003 Van Streat Highway, Nicholls, GA 31554 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538103 | Agatha Nonye Okoye | Pharmacist | 5300 Bridle Point Pkwy, Snellville, GA 30039-2715 | 2020-11-05 |
| 1861093155 | Mohamed J Bah | Pharmacist | 2965 Olivine Dr, Dacula, GA 30019-7646 | 2020-11-04 |
| 1841891249 | Himanshu Haridutt Desai | Pharmacist | 30983 Us-441 S, Commerce, GA 30529 | 2020-11-03 |
| 1720689219 | Olubunmi Adeniyi | Pharmacist | 524 Serene Waters Trl, Jonesboro, GA 30236-5495 | 2020-11-03 |
| 1174124572 | Jessica Rodriguez New | Pharmacist | 2892 Browns Bridge Road, Gainesville, GA 30504 | 2020-11-03 |
| 1063013613 | John Ellis Iv | Pharmacist | 135 Rudders Xing, Newnan, GA 30263-7032 | 2020-11-02 |
| 1992306591 | Connie Deverell Tam | Pharmacist | Walmart Pharmacy #1658, 2205 Harrison Rd, Thomson, GA 30824 | 2020-11-02 |
| 1922608520 | Sylvia Adams | Pharmacist | 1173 W Briar Gate Ct, Riverdale, GA 30296-3378 | 2020-11-01 |
| 1417557000 | Birtukan Tsegaye | Pharmacist | 2715 Henderson Rd, Tucker, GA 30084-2432 | 2020-10-31 |
| 1528668175 | Vishwa Patel | Pharmacist | 3604 Bellhaven Dr, Valdosta, GA 31605-1210 | 2020-10-31 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.