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Individual

DESAK G HICKS

Active
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Individual

DESAK G HICKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

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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