MEDICARE: NICOLA F ABO RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	18673	NV

General Provider Information

NPI Number	:	1194149914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLA F ABO RPH

Provider Business Mailing Address
First Line	:	4720 CLOUDY MORNING ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-4013
Country	:	US
Telephone Number	:	702-557-7985
Fax Number	:

Provider Business Practice Location Address
First Line	:	4720 CLOUDY MORNING ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-4013
Country	:	US
Telephone Number	:	702-557-7985
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2014
Last Update Date	:	02/13/2014

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