Provider Demographics
NPI:1942398144
Name:HEWETT DRUG COMPANY
Entity Type:Organization
Organization Name:HEWETT DRUG COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:CREEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-878-0641
Mailing Address - Street 1:121 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35950-2211
Mailing Address - Country:US
Mailing Address - Phone:256-878-0641
Mailing Address - Fax:256-878-0642
Practice Address - Street 1:121 S BROAD ST
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-2211
Practice Address - Country:US
Practice Address - Phone:256-878-0641
Practice Address - Fax:256-878-0642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100001875Medicaid