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Organization

LENDELL HICKS

Active
Other names
RIDGECREST PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
LENDELL HICKS (PIC)
(405) 682-1648
Entity
Organization

Contact information

Practice address
8220 S PENNSYLVANIA AVE, OKLAHOMA CITY, OK 73159-5230
(405) 682-1648
(405) 601-0794
Mailing address
8220 S PENNSYLVANIA AVE, OKLAHOMA CITY, OK 73159-5230
(405) 682-1648
(405) 601-0794

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
1-3336
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3717052
NCPDP PROVIDER IDENTIFICATION NUMBER
05
90003917945
OK
Enumeration date
11/08/2006
Last updated
01/28/2011
About Stedi
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Product
  • Claims
  • Eligibility checks
  • EDI platform