Provider Demographics
NPI:1295384758
Name:VERMILLION, NICHOLAS AARON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:AARON
Last Name:VERMILLION
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:789 STATE ROAD 39 BYP S
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46151-2127
Mailing Address - Country:US
Mailing Address - Phone:765-342-2121
Mailing Address - Fax:
Practice Address - Street 1:789 STATE ROAD 39 BYP S
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46151-2127
Practice Address - Country:US
Practice Address - Phone:765-342-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-08
Last Update Date:2019-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26026591A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist