Hicksville Pharmacy & Home Medical Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

022091050 Issued in OH

Legal business name

HICKSVILLE PHARMACY & HOME MEDICAL INC

Doing business as

HICKSVILLE PHARMACY

Practice address

116 E High St
Hicksville, OH 43526-1107

Phone

(419) 542-6218

Fax

(419) 542-8246

NPI assigned

Oct 11, 2006

Organization subpart

No

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

Authorized official

Name

Jonathon M MyersNPI 1861087447

Title

Owner

Phone

(419) 542-6218

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• HICKSVILLE PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in OH2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

Practitioners 1

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

• Jonathon M Myers, RPH

  • Pharmacist
  • Hicksville, OH
  • NPI 1861087447
  NPD Authorized official

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299715200000",
    "number": "1356439558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 E HIGH ST",
            "city": "HICKSVILLE",
            "state": "OH",
            "postal_code": "435261107",
            "telephone_number": "419-542-6218",
            "fax_number": "419-542-8246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 E HIGH ST",
            "city": "HICKSVILLE",
            "state": "OH",
            "postal_code": "435261107",
            "telephone_number": "419-542-6218",
            "fax_number": "419-542-8246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HICKSVILLE PHARMACY & HOME MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2011-03-10",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "JONATHON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-542-6218"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "022091050",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3613076",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3090560",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HICKSVILLE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cory T Hammond, PA
• Craig Eugene Hanson, M.D.
• Hickory Creek Healthcare Foundation, Inc.
• Hicksville Exempted Village Schools
• Hicksville Family Eye Care LLC
• Andrew David Hoffman, O.D.
• Samantha Jo Kimpel
• Natallia Lamantia
• Julanne Marie Luderman, RD, LD
• Tara L Lynchard, CNM, FNP-C

• Community/Retail Pharmacy in Hicksville, OH
• Providers in Hicksville, OH by specialty
• Community/Retail Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.