Organization
HICKMANS PRESCRIPTION DRUGGIST INC
Active
Other names
HICKMANS PRESCRIPTION DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HICKMAN RPH (PIC)
(304) 425-2188
Entity
Organization
Contact information
Practice address
199 12TH STREET EXT, PRINCETON, WV 24740-2352
(304) 425-2188
(304) 425-2189
Mailing address
199 12TH STREET EXT, PRINCETON, WV 24740-2352
(304) 425-2188
(304) 425-2189
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0550120
WV
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0141947000
—
WV
01
—
2109476
PK
—
Enumeration date
06/05/2006
Last updated
03/31/2017
Update your record
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