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General NPI Number Information
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NPI Number | 1740066182
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Entity Type | Individual
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Provider Name | NICHOLAS CHRISTOPHER PELLETIER PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 09/01/2023
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Last Update Date | 09/01/2023
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Provider Practice Location Address
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Address Line | 8546 S TAMIAMI TRL
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City | SARASOTA
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State | FL
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Zip | 34238-3031
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Country | US
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Telephone | 941-918-1514
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Fax |
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Provider Business Mailing Address
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Address Line | 6143 BELINA CT
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City | SARASOTA
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State | FL
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Zip | 34238-2889
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Country | US
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Telephone | 860-659-7464
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS66252
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License Number State | FL
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