MEDICARE: NIMBLE PHARMACY 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	3336C0003X	Community/Retail Pharmacy	Y007578	AZ

General Provider Information

NPI Number	:	1841795887
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NIMBLE PHARMACY INC

Provider Business Mailing Address
First Line	:	1134 CRANE ST STE 100
Second Line	:
City	:	MENLO PARK
State	:	CA
Zip	:	94025-4329
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3702 E ROESER RD STE 5
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85040-9047
Country	:	US
Telephone Number	:	866-966-4625
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TALHA WAQAR
Credential	:
Telephone Number	:	866-966-4625

Provider Enumeration Date	:	03/29/2018
Last Update Date	:	03/29/2018

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Directions to “NIMBLE PHARMACY INC ” Practice Location

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