Provider Demographics
NPI:1568477925
Name:BSW INC
Entity Type:Organization
Organization Name:BSW INC
Other - Org Name:HOWELL AND HEGGIE DRUG COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:RAEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-653-6441
Mailing Address - Street 1:389 NW DEPOT ST
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:MS
Mailing Address - Zip Code:39063-3800
Mailing Address - Country:US
Mailing Address - Phone:662-653-6441
Mailing Address - Fax:662-653-3806
Practice Address - Street 1:389 NW DEPOT ST
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:MS
Practice Address - Zip Code:39063-3800
Practice Address - Country:US
Practice Address - Phone:662-653-6441
Practice Address - Fax:662-653-3806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
MS001983336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2050710OtherPK
MS0330640Medicaid
4813210001Medicare NSC