Healthcare Provider Details

I. General information

NPI: 1922931021
Provider Name (Legal Business Name): BRIANNA HICKS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5707 VETERANS PKWY
COLUMBUS GA
31904-9003
US

IV. Provider business mailing address

5707 VETERANS PKWY
COLUMBUS GA
31904-9003
US

V. Phone/Fax

Practice location:
  • Phone: 706-322-6253
  • Fax: 706-322-8995
Mailing address:
  • Phone: 706-322-6253
  • Fax: 706-322-8995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH036208
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: