Provider Demographics
NPI:1316417108
Name:HILL, RICK
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 W RANDOLPH AVE
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-3834
Mailing Address - Country:US
Mailing Address - Phone:580-237-1535
Mailing Address - Fax:580-237-0688
Practice Address - Street 1:811 W RANDOLPH AVE
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-3834
Practice Address - Country:US
Practice Address - Phone:580-237-1535
Practice Address - Fax:580-237-0688
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-05
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10476183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist