Provider Demographics
NPI:1730668708
Name:HOCKS PHARMACY INC
Entity Type:Organization
Organization Name:HOCKS PHARMACY INC
Other - Org Name:HOCKS PIQUA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-898-5803
Mailing Address - Street 1:535 S DIXIE DR
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:OH
Mailing Address - Zip Code:45377-2557
Mailing Address - Country:US
Mailing Address - Phone:937-898-5803
Mailing Address - Fax:937-898-9340
Practice Address - Street 1:649 W HIGH ST
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-2149
Practice Address - Country:US
Practice Address - Phone:937-381-6550
Practice Address - Fax:937-381-6551
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOCKS PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02320000173336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0232000017OtherSTATE PHARMACY LICENSE
OH0232000017OtherSTATE PHARMACY LICENSE