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General NPI Number Information
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NPI Number | 1982219036
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Entity Type | Individual
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Provider Name | NICHOLAS MARPLES PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/14/2020
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Last Update Date | 09/14/2020
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Provider Practice Location Address
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Address Line | 5200 N CROATAN HWY
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City | KITTY HAWK
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State | NC
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Zip | 27949-3990
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Country | US
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Telephone | 252-261-7999
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Fax |
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Provider Business Mailing Address
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Address Line | 184 CULPEPPER RD
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City | SOUTH MILLS
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State | NC
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Zip | 27976-9796
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Country | US
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Telephone | 252-455-7963
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28518
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License Number State | NC
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