Provider Demographics
NPI:1851501316
Name:NIKKI'S APOTHECARY, LLC
Entity Type:Organization
Organization Name:NIKKI'S APOTHECARY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NIGHSTY
Authorized Official - Middle Name:
Authorized Official - Last Name:JEGHER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:713-733-7424
Mailing Address - Street 1:8610 MARTIN LUTHER KING JR. BLVD STE. A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77033
Mailing Address - Country:US
Mailing Address - Phone:713-733-7424
Mailing Address - Fax:713-733-1885
Practice Address - Street 1:8610 MARTIN LUTHER KING JR. BLVD STE. A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77033
Practice Address - Country:US
Practice Address - Phone:713-733-7424
Practice Address - Fax:713-733-1885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX016763336C0003X
TX318753336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4522644OtherNABP