Provider Demographics
NPI:1437556131
Name:NIKI LLC
Entity Type:Organization
Organization Name:NIKI LLC
Other - Org Name:HIGH ST DISCOUNT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIRTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-435-2751
Mailing Address - Street 1:30 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-1846
Mailing Address - Country:US
Mailing Address - Phone:240-435-2751
Mailing Address - Fax:240-607-6754
Practice Address - Street 1:30 HIGH ST
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-1846
Practice Address - Country:US
Practice Address - Phone:240-435-2751
Practice Address - Fax:240-607-6754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy