Organization
HICKS PHARMACY LLC
Active
Other names
Hicks Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH OLIVER HICKS RPH (OWNER)
(336) 591-4345
Entity
Organization
Contact information
Practice address
1072 N MAIN ST, STE 103, WALNUT COVE, NC 27052-9312
(336) 591-4345
(336) 591-3435
Mailing address
PO BOX 128, WALNUT COVE, NC 27052-0128
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2095
NC
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0855023
—
NC
01
—
3411890
OTHER ID NUMBER
—
05
—
7701174
—
NC
Enumeration date
06/10/2005
Last updated
08/10/2023
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