Healthcare Provider Details

I. General information

NPI: 1457411555
Provider Name (Legal Business Name): NANTUCKET ISLAND DRUG CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 PLEASANT ST
NANTUCKET MA
02554-4003
US

IV. Provider business mailing address

122 PLEASANT ST
NANTUCKET MA
02554-4003
US

V. Phone/Fax

Practice location:
  • Phone: 508-228-6400
  • Fax: 508-228-1375
Mailing address:
  • Phone: 508-228-6400
  • Fax: 508-228-1375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2953
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number2953
License Number StateMA

VIII. Authorized Official

Name: MR. ALLAN BELL
Title or Position: OWNER
Credential: RPH
Phone: 508-228-6400