Provider Demographics
NPI:1891543328
Name:NAUTILUS PHARMACY SERVICES LLC
Entity type:Organization
Organization Name:NAUTILUS PHARMACY SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:BIEURANCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-986-7827
Mailing Address - Street 1:9796 VALE ST NW
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-5546
Mailing Address - Country:US
Mailing Address - Phone:612-986-7827
Mailing Address - Fax:
Practice Address - Street 1:5209 LINBAR DR STE 603
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-1027
Practice Address - Country:US
Practice Address - Phone:615-621-1799
Practice Address - Fax:615-621-1789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-09
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy