Richard S Nicholas, PHARMD, ND
Individual provider Active NPI Pharmacist · Duffield, VA
NPI 1689998189 · NPPES record last updated Mar 26, 2010
Key facts
- NPI
- 1689998189
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0202209727 (VA)
- Practice address
- 121 Advanced Technology Drive
Duffield, VA 24244 - Phone
- (276) 431-2648
- Fax
- (276) 431-2082
- NPI assigned
- Mar 26, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NT00001647 | WA | MD | Naturopath |
| 11096 | NV | MD | Pharmacist |
| 0202209727 | VA | MD | Pharmacist |
| PH00044799 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holston Medical Group PC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | NT00001647 | WA | |
| Pharmacist | 183500000X | 0202209727 | VA | Yes |
| Pharmacist | 183500000X | 11096 | NV | |
| Pharmacist | 183500000X | PH00044799 | WA |
Addresses
Primary practice location
121 Advanced Technology Drive
Duffield, VA 24244
Mailing address
204 Winterbrook Cir
Kingsport, TN 37663-4409
Phone (276) 431-2648
Other providers in Duffield, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 26, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.