NPIMap

Organization Active NPI

Niki LLC

Doing business as High St Discount Pharmacy

  • Community/Retail Pharmacy
  • Waldorf, MD
National Provider Identifier
1437556131
Registry record updated Nov 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
NIKI LLC
Doing business as
High St Discount Pharmacy
Practice address
30 High St
Waldorf, MD 20602-1846
Phone
(240) 435-2751
Fax
(240) 607-6754
NPI assigned
Nov 24, 2014
Last updated
Nov 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kirtan Patel
Title
President
Phone
(240) 435-2751

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

30 High St
Waldorf, MD 20602-1846

Mailing address

30 High St
Waldorf, MD 20602-1846
Phone (240) 435-2751

Other names 1

  • High St Discount Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190325001816 MD Part B Supplier - Mass Immunization (Roster Biller Only) 1850649799 Practice locations: Waldorf, MD

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416787200000",
    "number": "1437556131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HIGH ST",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206021846",
            "telephone_number": "240-435-2751",
            "fax_number": "240-607-6754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HIGH ST",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206021846",
            "telephone_number": "240-435-2751",
            "fax_number": "240-607-6754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIKI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-24",
        "last_updated": "2014-11-24",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "KIRTAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "240-435-2751"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "High St Discount Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.