Provider Demographics
NPI:1871842393
Name:PIKULA, NANCY BETH (RPH)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:BETH
Last Name:PIKULA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9718 N KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-4013
Mailing Address - Country:US
Mailing Address - Phone:843-497-8625
Mailing Address - Fax:843-497-8893
Practice Address - Street 1:9718 N KINGS HWY
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4013
Practice Address - Country:US
Practice Address - Phone:843-497-8625
Practice Address - Fax:843-497-8893
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC010179183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist