Provider Demographics
NPI:1932549169
Name:REID, NICHOLAS L (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:L
Last Name:REID
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3611 GROOMETOWN RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-6525
Mailing Address - Country:US
Mailing Address - Phone:336-856-7437
Mailing Address - Fax:336-294-2440
Practice Address - Street 1:3611 GROOMETOWN RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-6525
Practice Address - Country:US
Practice Address - Phone:336-856-7437
Practice Address - Fax:336-294-2440
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23343183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist