Provider Demographics
NPI:1508914508
Name:NFGM LLC
Entity Type:Organization
Organization Name:NFGM LLC
Other - Org Name:APOTHECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:NAGY
Authorized Official - Middle Name:
Authorized Official - Last Name:WASSEF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-442-0669
Mailing Address - Street 1:145 BARNSTABLE RD
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-2901
Mailing Address - Country:US
Mailing Address - Phone:508-775-9254
Mailing Address - Fax:508-775-3477
Practice Address - Street 1:145 BARNSTABLE RD
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-2901
Practice Address - Country:US
Practice Address - Phone:508-775-9254
Practice Address - Fax:508-775-3477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2016-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MADS900713336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110108161AMedicaid
2038938OtherPK
2038938OtherPK
4777600001Medicare NSC
VT1008745Medicaid