1528051380 NPI number — DR. NICOLE CULHANE PHARM D BCPS

Table of content: DR. NICOLE CULHANE PHARM D BCPS (NPI 1528051380)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528051380 NPI number — DR. NICOLE CULHANE PHARM D BCPS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CULHANE
Provider First Name:
NICOLE
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARM D BCPS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528051380
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
WILKES UNIVERSITY
Provider Second Line Business Mailing Address:
84 WEST SOUTH STREET SLC 336
Provider Business Mailing Address City Name:
WILKES BARRE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18766-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-408-4297
Provider Business Mailing Address Fax Number:
570-408-7729

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
FAMILY CARE CENTER
Provider Second Line Business Practice Location Address:
2 SHARPE ST
Provider Business Practice Location Address City Name:
KINGSTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-552-8976
Provider Business Practice Location Address Fax Number:
570-552-8958
Provider Enumeration Date:
08/26/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1835P1200X , with the licence number:  RP043576R , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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