Provider Demographics
NPI:1891823811
Name:ALICK'S DRUGS INC.
Entity Type:Organization
Organization Name:ALICK'S DRUGS INC.
Other - Org Name:ALICK'S IVONYX ADO ALICK'S
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-271-4900
Mailing Address - Street 1:PO BOX 8334
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46660-8334
Mailing Address - Country:US
Mailing Address - Phone:574-271-4900
Mailing Address - Fax:574-271-4902
Practice Address - Street 1:17187 STATE ROAD 23
Practice Address - Street 2:SUITE 305
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46635-1521
Practice Address - Country:US
Practice Address - Phone:574-271-4900
Practice Address - Fax:574-271-4902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN60001963A332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN0243240001Medicare ID - Type Unspecified