Healthcare Provider Details

I. General information

NPI: 1073996831
Provider Name (Legal Business Name): NICKOLAS KAI JONES PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: KAI JONES PHARMD

II. Dates (important events)

Enumeration Date: 06/29/2015
Last Update Date: 09/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 S NC HWY 124
HICKORY NC
28602-9130
US

IV. Provider business mailing address

2700 S NC HWY 124
HICKORY NC
28602-9130
US

V. Phone/Fax

Practice location:
  • Phone: 828-294-0058
  • Fax:
Mailing address:
  • Phone: 828-294-0058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number25152
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: