Provider Demographics
NPI:1467084228
Name:NICOLAS LOGISTICS LLC
Entity Type:Organization
Organization Name:NICOLAS LOGISTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DUKENSON
Authorized Official - Middle Name:
Authorized Official - Last Name:NICOLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-684-4844
Mailing Address - Street 1:7628 MARGATE BLVD
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-3352
Mailing Address - Country:US
Mailing Address - Phone:954-684-4844
Mailing Address - Fax:
Practice Address - Street 1:7628 MARGATE BLVD
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-3352
Practice Address - Country:US
Practice Address - Phone:954-684-4844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NICOLAS LOGISTICS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care