Provider Demographics
NPI:1972838738
Name:HICKLE, JAMES (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:HICKLE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 TROUTTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HUNKER
Mailing Address - State:PA
Mailing Address - Zip Code:15639-1288
Mailing Address - Country:US
Mailing Address - Phone:724-925-8023
Mailing Address - Fax:
Practice Address - Street 1:8731 ROUTE 30
Practice Address - Street 2:
Practice Address - City:NORTH HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:15642-3241
Practice Address - Country:US
Practice Address - Phone:724-978-0110
Practice Address - Fax:724-978-0089
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP033986R183500000X
WV4191183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist