Provider Demographics
NPI:1912593823
Name:HICKS, MARTHA A (RPH)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:A
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 1:270 ROUTE 23
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:07416-2128
Mailing Address - Country:US
Mailing Address - Phone:973-827-1806
Mailing Address - Fax:973-827-0949
Practice Address - Street 1:270 ROUTE 23
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NJ
Practice Address - Zip Code:07416-2128
Practice Address - Country:US
Practice Address - Phone:973-827-1806
Practice Address - Fax:973-827-0949
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01903600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist