Healthcare Provider Details

I. General information

NPI: 1891468344
Provider Name (Legal Business Name): NICHOLE FLASPOHLER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2021
Last Update Date: 07/30/2021
Certification Date: 07/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 TREMONT ST
BOSTON MA
02116-5603
US

IV. Provider business mailing address

102 TYLER ST APT 3
BOSTON MA
02111-1828
US

V. Phone/Fax

Practice location:
  • Phone: 513-310-9241
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberPH240188
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: