Provider Demographics
NPI:1356838890
Name:HICKORY DRUGS
Entity Type:Organization
Organization Name:HICKORY DRUGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-798-8434
Mailing Address - Street 1:202 BEACON CV
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-5892
Mailing Address - Country:US
Mailing Address - Phone:678-798-8434
Mailing Address - Fax:678-798-8435
Practice Address - Street 1:6679 HICKORY FLAT HWY
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-9225
Practice Address - Country:US
Practice Address - Phone:678-798-8434
Practice Address - Fax:678-798-8435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy