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NPI Code Detail

MEDICARE: DR. NICHOLAS JAMES MCBRIDE PHARMD

MEDICARE: DR. NICHOLAS JAMES MCBRIDE PHARMD
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
1183500000XPharmacist26025554AIN

General Provider Information

NPI Number : 1952716904
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICHOLAS JAMES MCBRIDE PHARMD
Provider Business Mailing Address
First Line : 10170 MAYSVILLE RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46835-9589
Country : US
Telephone Number : 260-486-7295
Fax Number :
Provider Business Practice Location Address
First Line : 10170 MAYSVILLE RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46835-9589
Country : US
Telephone Number : 260-486-7295
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2014
Last Update Date : 06/29/2014

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