Stanley D. Hicks, DPH
Individual provider Active NPI Pharmacist · Ashland City, TN
NPI 1679062889 · NPPES record last updated May 2, 2018
Key facts
- NPI
- 1679062889
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 07247 (TN)
- Practice address
- 1626 Highway 12 S
Ashland City, TN 37015-3322 - Phone
- (615) 792-7720
- Fax
- (615) 792-5346
- NPI assigned
- May 2, 2018
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07247 | TN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 07247 | TN | Yes |
Addresses
Primary practice location
1626 Highway 12 S
Ashland City, TN 37015-3322
Mailing address
1626 Highway 12 S
Ashland City, TN 37015-3322
Phone (615) 792-7720
Other providers in Ashland City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.