Provider Demographics
NPI:1881294270
Name:NICHOLS, ERIC R (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:R
Last Name:NICHOLS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 ZANE GREY RD
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:OH
Mailing Address - Zip Code:43767-9725
Mailing Address - Country:US
Mailing Address - Phone:740-541-4980
Mailing Address - Fax:
Practice Address - Street 1:61205 SOUTHGATE RD
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-8002
Practice Address - Country:US
Practice Address - Phone:740-439-5314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03134651183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist