Provider Demographics
NPI:1679175251
Name:VEREEN, HEWSTON (RPH)
Entity Type:Individual
Prefix:
First Name:HEWSTON
Middle Name:
Last Name:VEREEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98137 LITTLE PINEY ISLAND PT
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32034-0856
Mailing Address - Country:US
Mailing Address - Phone:561-262-9888
Mailing Address - Fax:
Practice Address - Street 1:464016 STATE ROAD 200
Practice Address - Street 2:
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097-6339
Practice Address - Country:US
Practice Address - Phone:561-261-9846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS13635183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist