Provider Demographics
NPI:1871887729
Name:CULP, NICHOLAS EDWARD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:EDWARD
Last Name:CULP
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:594 RIVER HWY
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-6829
Mailing Address - Country:US
Mailing Address - Phone:704-799-1477
Mailing Address - Fax:704-799-1477
Practice Address - Street 1:4271 TAMIAMI TRL S
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-5131
Practice Address - Country:US
Practice Address - Phone:941-497-8875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18415183500000X
FLPS48829183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist