# BOSTICK'S PRESCRIPTION PHARMACY, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891857454
- **Authorized official:** MR. ALVA DANIEL BOSTICK RPH (PRESIDENT)
- **Authorized official phone:** (740) 289-2269

## Contact information

- **Practice address:** 549 S. WEST ST, PIKETON, OH 45661-0686
- **Practice address phone:** (740) 289-2269
- **Practice address fax:** (740) 289-4586
- **Mailing address:** 549 S. WEST ST, PO BOX 686, PIKETON, OH 45661-0686
- **Mailing address phone:** (740) 289-2269
- **Mailing address fax:** (740) 289-4586

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | OH | Yes |

## Other

- **Enumeration date:** 12/13/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0387531 | — | OH |
| 01 | — | 3636062 | NCPDP | OH |