Provider Demographics
NPI:1912503046
Name:ARMELLINO, NICKLAS DAVID (PHARMD)
Entity Type:Individual
Prefix:
First Name:NICKLAS
Middle Name:DAVID
Last Name:ARMELLINO
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 1:664 CHEROKEE CROSSING
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:NC
Mailing Address - Zip Code:28789
Mailing Address - Country:US
Mailing Address - Phone:828-497-2273
Mailing Address - Fax:828-497-2873
Practice Address - Street 1:664 CHEROKEE CROSSING
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:NC
Practice Address - Zip Code:28789
Practice Address - Country:US
Practice Address - Phone:828-497-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29369183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist