Provider Demographics
NPI:1619578697
Name:DRUMMOND, NICOLE LOUISE
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:LOUISE
Last Name:DRUMMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S RADFORD WAY
Mailing Address - Street 2:
Mailing Address - City:EAST FALLOWFIELD TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:19320-4346
Mailing Address - Country:US
Mailing Address - Phone:610-663-5429
Mailing Address - Fax:
Practice Address - Street 1:698 DOWNINGTOWN PIKE
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-2226
Practice Address - Country:US
Practice Address - Phone:610-430-6180
Practice Address - Fax:610-430-6156
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP043436L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist