Provider Demographics
NPI:1962022442
Name:HEWITT DRUG
Entity Type:Organization
Organization Name:HEWITT DRUG
Other - Org Name:LYNN'S PHARMACY HEWITT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CPHT
Authorized Official - Prefix:
Authorized Official - First Name:TERI
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:WAGONER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-666-5000
Mailing Address - Street 1:511 N HEWITT DR STE 1
Mailing Address - Street 2:
Mailing Address - City:HEWITT
Mailing Address - State:TX
Mailing Address - Zip Code:76643-3093
Mailing Address - Country:US
Mailing Address - Phone:254-666-5000
Mailing Address - Fax:
Practice Address - Street 1:511 N HEWITT DR STE 1
Practice Address - Street 2:
Practice Address - City:HEWITT
Practice Address - State:TX
Practice Address - Zip Code:76643-3093
Practice Address - Country:US
Practice Address - Phone:254-666-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-24
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy