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
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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