Provider Demographics
NPI:1811972649
Name:HOCKS PHARMACY INC
Entity type:Organization
Organization Name:HOCKS PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:R
Authorized Official - Last Name:BARTONE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
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:45377-2543
Mailing Address - Country:US
Mailing Address - Phone:937-898-5803
Mailing Address - Fax:937-898-9340
Practice Address - Street 1:732 W NATIONAL RD
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:OH
Practice Address - Zip Code:45377-1015
Practice Address - Country:US
Practice Address - Phone:937-898-5803
Practice Address - Fax:937-898-9340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2968883Medicaid
OH000000003252OtherANTHEM
OH000000003252OtherANTHEM
OH0546470001Medicare ID - Type Unspecified
OH=========OtherGENERIC INSURANCE CO