Healthcare Provider Details

I. General information

NPI: 1851699078
Provider Name (Legal Business Name): NICHOLAS ALLEN BORSAY PHARM. D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2011
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2014 S CROATAN HWY
KILL DEVIL HILLS NC
27948-8723
US

IV. Provider business mailing address

2014 S CROATAN HWY
KILL DEVIL HILLS NC
27948-8723
US

V. Phone/Fax

Practice location:
  • Phone: 252-441-7111
  • Fax: 252-441-3132
Mailing address:
  • Phone: 252-441-7111
  • Fax: 252-441-3132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19846
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH04752
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: