Provider Demographics
NPI:1669809976
Name:RICK'S PHARMACY, INC.
Entity type:Organization
Organization Name:RICK'S PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:T
Authorized Official - Last Name:SANSOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-851-1345
Mailing Address - Street 1:1762 WINCHESTER RD NE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35811-9191
Mailing Address - Country:US
Mailing Address - Phone:256-851-1345
Mailing Address - Fax:
Practice Address - Street 1:1878 JEFF RD
Practice Address - Street 2:SUITE D
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-4260
Practice Address - Country:US
Practice Address - Phone:256-489-7632
Practice Address - Fax:256-489-7637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-01
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1142103336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy