Provider Demographics
NPI:1689909632
Name:3-D NICHOLS & CO. INC.
Entity Type:Organization
Organization Name:3-D NICHOLS & CO. INC.
Other - Org Name:SALON 2000
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-958-7901
Mailing Address - Street 1:80 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-2314
Mailing Address - Country:US
Mailing Address - Phone:508-695-0021
Mailing Address - Fax:508-809-6329
Practice Address - Street 1:80 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-2314
Practice Address - Country:US
Practice Address - Phone:508-695-0021
Practice Address - Fax:508-809-6329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA40040335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110082343AMedicare PIN