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General NPI Number Information
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NPI Number | 1144891318
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Entity Type | Individual
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Provider Name | MR. SHERWIN PRESTON HICKS
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Gender | Male
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Dates
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Enumeration Date | 07/08/2021
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Last Update Date | 07/08/2021
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Provider Practice Location Address
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Address Line | 333 E WYOMING AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19120-4453
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Country | US
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Telephone | 215-333-1555
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Fax | 267-367-5554
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Provider Business Mailing Address
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Address Line | 333 E WYOMING AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19120-4453
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Country | US
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Telephone | 215-333-1555
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Fax | 267-367-5554
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP045780L
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License Number State | PA
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