Provider Demographics
NPI:1184726762
Name:HICKS, KATHERINE MCGILL (RPH)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MCGILL
Last Name:HICKS
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 1:1020 RICHLAND AVE W
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-3224
Mailing Address - Country:US
Mailing Address - Phone:803-649-7437
Mailing Address - Fax:803-649-2062
Practice Address - Street 1:1020 RICHLAND AVE W
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-3224
Practice Address - Country:US
Practice Address - Phone:803-649-7437
Practice Address - Fax:803-649-2062
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5766183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC5766OtherPHARMACIST