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General NPI Number Information
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NPI Number | 1891823811
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Entity Type | Organization
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Legal Business Name | ALICK'S DRUGS INC.
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17187 STATE ROAD 23 SUITE 305
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City | SOUTH BEND
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State | IN
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Zip | 46635-1521
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Country | US
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Telephone | 574-271-4900
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Fax | 574-271-4902
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Provider Business Mailing Address
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Address Line | PO BOX 8334
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City | SOUTH BEND
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State | IN
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Zip | 46660-8334
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Country | US
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Telephone | 574-271-4900
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Fax | 574-271-4902
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Authorized Official
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Title or Position | CONTROLLER
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Name | MS. JUDY RICHMOND
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Credential |
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Telephone | 574-271-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 60001963A
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License Number State | IN
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