MEDICARE: NICOLAS TRIANA-BALTZER 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	75990	CA

General Provider Information

NPI Number	:	1982461679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLAS TRIANA-BALTZER RPH

Provider Business Mailing Address
First Line	:	2310 DOGWOOD RD
Second Line	:
City	:	MCKINLEYVILLE
State	:	CA
Zip	:	95519-4019
Country	:	US
Telephone Number	:	843-283-8031
Fax Number	:

Provider Business Practice Location Address
First Line	:	1424 BROADWAY
Second Line	:
City	:	EUREKA
State	:	CA
Zip	:	95501-0134
Country	:	US
Telephone Number	:	707-441-1900
Fax Number	:

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

Provider Enumeration Date	:	02/29/2024
Last Update Date	:	04/18/2024

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Directions to “ NICOLAS TRIANA-BALTZER RPH” Practice Location

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