MEDICARE: NICHOLAS MCANDREW PHARMD

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	A1-0004942	DE
2	183500000X	Pharmacist	28RI03770400	NJ
3	183500000X	Pharmacist	RPI005220	PA
4	183500000X	Pharmacist	28RJ06712	NJ
5	183500000X	Pharmacist	RP442753	PA

General Provider Information

NPI Number	:	1427646082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS MCANDREW PHARMD

Provider Business Mailing Address
First Line	:	1701 PAOLI PIKE
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-6054
Country	:	US
Telephone Number	:	484-343-5669
Fax Number	:

Provider Business Practice Location Address
First Line	:	3400 EDGMONT AVE
Second Line	:
City	:	BROOKHAVEN
State	:	PA
Zip	:	19015-2804
Country	:	US
Telephone Number	:	610-872-5418
Fax Number	:	610-872-1969

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

Provider Enumeration Date	:	01/08/2021
Last Update Date	:	01/08/2021

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