Provider Demographics
NPI:1417379595
Name:NICKAL INC
Entity Type:Organization
Organization Name:NICKAL INC
Other - Org Name:RICHWOOD PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-943-2233
Mailing Address - Street 1:24 W OTTAWA ST
Mailing Address - Street 2:
Mailing Address - City:RICHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:43344-1139
Mailing Address - Country:US
Mailing Address - Phone:740-943-2233
Mailing Address - Fax:740-943-2323
Practice Address - Street 1:24 W OTTAWA ST
Practice Address - Street 2:
Practice Address - City:RICHWOOD
Practice Address - State:OH
Practice Address - Zip Code:43344-1139
Practice Address - Country:US
Practice Address - Phone:740-943-2233
Practice Address - Fax:740-943-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-09
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRTP0223744503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2143844OtherPK