Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. NATHAN TILLIS, PHARM. D.

Active Sole Proprietor

Pharmacist · GREEN COVE SPRINGS, FL

Registration Details

NPI Number: 1578897658
Provider Type: Individual
Gender: Male
NPI Issued: Sep 23, 2009 (16.640297207305 yrs)
Last Updated: Mar 3, 2013
Licenses: PS34236 (FL)

RPH020986 (GA)

PH00053534 (WA)
Sole Proprietor: Yes

Practice Information

Address: 2851 HENLEY RD

WINN DIXIE

GREEN COVE SPRINGS, FL, 320437204
Browse FL providers · Browse ZIP 32043
Phone: 9048996902
Fax: 9042913288
Primary Specialty: Pharmacist
183500000X
Additional Specialty: Pharmacist
Additional Specialty: Pharmacist

Other Pharmacist Providers in GREEN COVE SPRINGS, FL

Name	Credential	NPI
MRS. DIANE ELLEN FORHAN	RPH	1649342973
NORMA S. KEMPTON	RPH	1417091976
LAWRENCE MATTHEW SMITH	PHARMD	1073806402
MR. VENKATA BELLAMKONDA	B.PHARMACY, M.S	1174804660
AMY PHAN	—	1356622559
MRS. DIANE MARIE TOLOSKY	RPH	1275814303

Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.