MEDICARE: HOCKS PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	333600000X	Pharmacy
2	3336C0004X	Compounding Pharmacy
3	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2075666	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477638070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOCKS PHARMACY INC

Provider Business Mailing Address
First Line	:	535 S DIXIE DR
Second Line	:
City	:	VANDALIA
State	:	OH
Zip	:	45377-2557
Country	:	US
Telephone Number	:	937-462-8331
Fax Number	:	937-462-8441

Provider Business Practice Location Address
First Line	:	127 S CHILLICOTHE ST
Second Line	:
City	:	S CHARLESTON
State	:	OH
Zip	:	45368-9786
Country	:	US
Telephone Number	:	937-462-8331
Fax Number	:	937-462-8441

Authorized Official
Title or Position	:	CONTROLLER
Name	:	MICHAEL J SIMON
Credential	:
Telephone Number	:	937-898-5803

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	09/03/2020

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Directions to “HOCKS PHARMACY INC ” Practice Location

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