Provider Demographics
NPI:1528373925
Name:RICKS, RENEE D (RPH)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:D
Last Name:RICKS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 HIGHWAY 19
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-5106
Mailing Address - Country:US
Mailing Address - Phone:828-835-3961
Mailing Address - Fax:828-835-3965
Practice Address - Street 1:2060 HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-5106
Practice Address - Country:US
Practice Address - Phone:828-835-3961
Practice Address - Fax:828-835-3965
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14731183500000X
NC25755183500000X
GARPH028989183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist