Provider Demographics
NPI:1174666002
Name:HILLS DRUG STORE
Entity Type:Organization
Organization Name:HILLS DRUG STORE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MAX
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:870-994-2425
Mailing Address - Street 1:1238A HIGHWAY 62 412
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:AR
Mailing Address - Zip Code:72542-9468
Mailing Address - Country:US
Mailing Address - Phone:870-994-2425
Mailing Address - Fax:870-994-2807
Practice Address - Street 1:1238A HIGHWAY 62 412
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:AR
Practice Address - Zip Code:72542-9468
Practice Address - Country:US
Practice Address - Phone:870-994-2425
Practice Address - Fax:870-994-2807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR03155146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARAR03155OtherSTATE