Nicholas Pharmacy Inc

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

NICHOLAS PHARMACY INC

Practice address

421 Main St
Summersville, WV 26651

Phone

(304) 872-0517

Fax

(304) 872-6644

NPI assigned

Jan 11, 2006

Organization subpart

No

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

Authorized official

Name

Michael Clark, RRT

Title

General Manager

Phone

(304) 872-0517

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 2

• NICHOLAS PHARMACY Doing business as
• Nicholas Home Medical Doing business as

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rebecca J Altizer, R PH

  • Pharmacist
  • Summersville, WV
  • NPI 1497951040
  NPD (past)
• Christina R Johnson, R.PH

  • Pharmacist
  • Summersville, WV
  • NPI 1043496086
  NPD (past)
• Joseph Miller, R. PH.

  • Pharmacist
  • Summersville, WV
  • NPI 1477758605
  NPD (past)
• Rex A Tremmel, R. PH.

  • Pharmacist
  • Summersville, WV
  • NPI 1801091020
  NPD (past)

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Locations

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531785600000",
    "number": "1962481697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 MAIN ST",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266511343",
            "telephone_number": "304-872-0517",
            "fax_number": "304-872-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 MAIN ST",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "26651",
            "telephone_number": "304-872-0517",
            "fax_number": "304-872-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLAS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2018-07-17",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "304-872-0517",
        "authorized_official_credential": "RRT"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0143752000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2109949",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NICHOLAS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nicholas Home Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicholas County Board of Education
• Nicholas County Board of Education
• Nicholas County Board of Health
• Nicholas County Community Corrections
• Nicholas Emergency Group, PLLC
• Nicholas-Webster Home Health
• Abby Danielle Nicholas
• Jeremy Andrew Nicholas
• Justine Nicole Nicholas
• Amy Renee Nichols

• All providers in Summersville, WV
• Oxygen Equipment & Supplies (DME) in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.