Provider Demographics
NPI:1922211945
Name:VOLLWEILER, NICOLE L (RPH)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:L
Last Name:VOLLWEILER
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 1:3332 HEMMINGWAY LN
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48144-9653
Mailing Address - Country:US
Mailing Address - Phone:734-856-1805
Mailing Address - Fax:
Practice Address - Street 1:9880 OLDE US #20
Practice Address - Street 2:
Practice Address - City:ROSSFORD
Practice Address - State:OH
Practice Address - Zip Code:43460-1716
Practice Address - Country:US
Practice Address - Phone:419-874-2471
Practice Address - Fax:419-874-2639
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-24663183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist