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General NPI Number Information
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NPI Number | 1609308543
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Entity Type | Organization
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Legal Business Name | NIKI LLC
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Dates
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Enumeration Date | 03/30/2017
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Last Update Date | 03/30/2017
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Provider Practice Location Address
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Address Line | 30 HIGH ST
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City | WALDORF
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State | MD
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Zip | 20602-1846
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Country | US
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Telephone | 201-744-0481
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Fax | 240-448-3302
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Provider Business Mailing Address
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Address Line | 30 HIGH ST
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City | WALDORF
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State | MD
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Zip | 20602-1846
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Country | US
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Telephone | 240-448-3301
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Fax | 240-448-3302
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Authorized Official
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Title or Position | PRESIDENT
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Name | KIRTAN PATEL
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Credential |
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Telephone | 240-448-3301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | P06652
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License Number State | MD
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