MEDICARE: MR. NICHOLAS ALLEN BORSAY PHARM. D

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	19846	NC
2	183500000X	Pharmacist	RPH04752	RI

General Provider Information

NPI Number	:	1851699078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NICHOLAS ALLEN BORSAY PHARM. D

Provider Business Mailing Address
First Line	:	2014 S CROATAN HWY
Second Line	:
City	:	KILL DEVIL HILLS
State	:	NC
Zip	:	27948-8723
Country	:	US
Telephone Number	:	252-441-7111
Fax Number	:	252-441-3132

Provider Business Practice Location Address
First Line	:	2014 S CROATAN HWY
Second Line	:
City	:	KILL DEVIL HILLS
State	:	NC
Zip	:	27948-8723
Country	:	US
Telephone Number	:	252-441-7111
Fax Number	:	252-441-3132

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

Provider Enumeration Date	:	03/11/2011
Last Update Date	:	03/11/2011

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