MEDICARE: NOZZLE NOLEN, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332900000X	Non-Pharmacy Dispensing Site	171W00000X	FL

General Provider Information

NPI Number	:	1326426339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOZZLE NOLEN, INC

Provider Business Mailing Address
First Line	:	5400 BROADWAY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2602
Country	:	US
Telephone Number	:	561-844-3544
Fax Number	:

Provider Business Practice Location Address
First Line	:	5400 BROADWAY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2602
Country	:	US
Telephone Number	:	561-844-3544
Fax Number	:

Authorized Official
Title or Position	:	ACCOUNTS PAYABLE
Name	:	MS. JUDY NEAL
Credential	:
Telephone Number	:	561-844-3544

Provider Enumeration Date	:	05/11/2015
Last Update Date	:	05/11/2015

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