Healthcare Provider Details

I. General information

NPI: 1750441952
Provider Name (Legal Business Name): R&K FERGUSON NANTUCKET LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 MAIN ST
NANTUCKET MA
02554-3542
US

IV. Provider business mailing address

45 MAIN ST PO BOX 1056
NANTUCKET MA
02554-3542
US

V. Phone/Fax

Practice location:
  • Phone: 508-228-0180
  • Fax: 508-325-7106
Mailing address:
  • Phone: 508-228-0180
  • Fax: 508-325-7106

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 TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number10324
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number10324
License Number StateMA

VIII. Authorized Official

Name: MR. KIP FERGUSON
Title or Position: OWNER
Credential:
Phone: 508-228-0180