# HICKSVILLE PHARMACY & HOME MEDICAL INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HICKSVILLE PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356439558
- **Authorized official:** JONATHON M MYERS (OWNER)
- **Authorized official phone:** (419) 542-6218

## Contact information

- **Practice address:** 116 E HIGH ST, HICKSVILLE, OH 43526-1107
- **Practice address phone:** (419) 542-6218
- **Practice address fax:** (419) 542-8246
- **Mailing address:** 116 E HIGH ST, HICKSVILLE, OH 43526-1107
- **Mailing address phone:** (419) 542-6218
- **Mailing address fax:** (419) 542-8246

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 022091050 | OH | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 10/11/2006
- **Last updated:** 03/10/2011