Individual
DESAK G HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
873 HIGHWAY 84, COFFEEVILLE, AL 36524-5012
(251) 276-3400
(251) 276-3562
Mailing address
873 HIGHWAY 84, COFFEEVILLE, AL 36524-5012
(251) 276-3400
(251) 276-3562
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
11671
AL
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
3336C0003X
Community/Retail Pharmacy
113345
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009501290
—
AL
Enumeration date
12/22/2008
Last updated
03/21/2011
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