NPIMap

Organization Active NPI

Hickmans Prescription Druggist Inc

  • Community/Retail Pharmacy
  • Princeton, WV
National Provider Identifier
1093757619
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
SP0552309 Issued in WV
Legal business name
HICKMANS PRESCRIPTION DRUGGIST INC
Doing business as
HICKMANS EAST PHARMACY
Practice address
306 Rogers St
Princeton, WV 24740-3600
Phone
(304) 425-1077
Fax
(304) 425-4250
NPI assigned
Jun 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John Hickman, RPHNPI 1174616494
Title
Pic
Phone
(304) 425-1077

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X SP0552309 WV Primary

Addresses

Primary practice location

306 Rogers St
Princeton, WV 24740-3600

Mailing address

306 Rogers St
Princeton, WV 24740-3600
Phone (304) 425-1077

Other identifiers 2

IdentifierTypeStateIssuer
0141947001MedicaidWV
2109475OtherPK

Other names 1

  • HICKMANS EAST PHARMACY Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479340800000",
    "number": "1093757619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 ROGERS ST",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247403600",
            "telephone_number": "304-425-1077",
            "fax_number": "304-425-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 ROGERS ST",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247403600",
            "telephone_number": "304-425-1077",
            "fax_number": "304-425-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HICKMANS PRESCRIPTION DRUGGIST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2016-11-17",
        "status": "A",
        "authorized_official_last_name": "HICKMAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "304-425-1077",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "SP0552309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0141947001",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2109475",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HICKMANS EAST PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Princeton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.