Provider Demographics
NPI:1841412939
Name:FEMIA, NICK P (RPH)
Entity Type:Individual
Prefix:
First Name:NICK
Middle Name:P
Last Name:FEMIA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6741 KYLE RIDGE POINTE
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9229
Mailing Address - Country:US
Mailing Address - Phone:330-286-3012
Mailing Address - Fax:330-726-5054
Practice Address - Street 1:8049 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-6154
Practice Address - Country:US
Practice Address - Phone:330-726-5130
Practice Address - Fax:330-726-5054
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-20538183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist