NICHOLLS PHARMACY LLC
NPI 1184748808
Pharmacy - Community/Retail Pharmacy in Nicholls, GA

Active since March 19, 2007CLIA 11D2172728 · Waiver
1003 VAN STREAT HWY, NICHOLLS, GA 31554(912) 345-1021(912) 345-1023 Get Directions Write a Review

NPPES record last updated: September 17, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Nicholls Pharmacy Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICHOLLS PHARMACY LLC (NPI 1184748808) is a healthcare organization registered as a community/retail pharmacy in Nicholls, Georgia and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through September 29, 2027 and lists Jan Scott, Owner,pres,pic,ao, as its authorized official.

NPPES Registry Identity

NPI1184748808
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameNICHOLLS PHARMACY LLC
Location Address1003 VAN STREAT HWYNicholls, GA 31554-5031
Mailing AddressPo Box 247Nicholls, GA 31554-0247 · (912) 345-1021 · Fax (912) 345-1023
Fax(912) 345-1023
Organization SubpartNo
Authorized OfficialJan ScottOwner,pres,pic,ao · (912) 345-1021
Enumeration DateMarch 19, 2007
Last NPPES UpdateSeptember 17, 2015
NPI 1184748808 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License Licensed in GA · PHRE009134
Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
1003 VAN STREAT HWY, Nicholls, GA 31554

Other Names 1

Doing Business AsNicholls Pharmacy Llc

Other Identifiers 2

Other2016489Pk
Medicaid569772164AGA

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2172728

Nicholls Pharmacy, LLC · Nicholls, GA
Active · expires Sep 29, 2027
CLIA Number11D2172728
Laboratory TypePharmacy
Certificate Effective DateSeptember 30, 2025
Certificate Expiration DateSeptember 29, 2027
Laboratory DirectorJan G. Scott
Laboratory Phone(912) 345-1021
Laboratory LocationNicholls Pharmacy, LLC1003 Van Streat Hwy, Nicholls, GA 31554
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist
1003 VAN STREAT HWY
NICHOLLS, GA 31554

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicholls Pharmacy LLC's NPI number?

The NPI number for Nicholls Pharmacy LLC is 1184748808. It was assigned to this organization in the NPPES registry on March 19, 2007.

Where is Nicholls Pharmacy LLC located?

Nicholls Pharmacy LLC is located at 1003 Van Streat Hwy, Nicholls, GA 31554. The listed phone number is (912) 345-1021.

What is Nicholls Pharmacy LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Nicholls Pharmacy LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2172728) is associated with this NPI, valid through September 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Nicholls Pharmacy LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 48 other insurers list Nicholls Pharmacy LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Nicholls Pharmacy LLC was last updated on September 17, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.