Healthcare Provider Details

I. General information

NPI: 1508914508
Provider Name (Legal Business Name): NFGM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 12/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 BARNSTABLE RD
HYANNIS MA
02601-2901
US

IV. Provider business mailing address

145 BARNSTABLE RD
HYANNIS MA
02601-2901
US

V. Phone/Fax

Practice location:
  • Phone: 508-775-9254
  • Fax: 508-775-3477
Mailing address:
  • Phone: 508-775-9254
  • Fax: 508-775-3477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberDS90071
License Number StateMA

VIII. Authorized Official

Name: NAGY WASSEF
Title or Position: PARTNER
Credential:
Phone: 860-442-0669