Provider Demographics
NPI:1669797544
Name:HILL, DEWITT LASHAY (PHARMD)
Entity type:Individual
Prefix:MR
First Name:DEWITT
Middle Name:LASHAY
Last Name:HILL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9329 CIELO DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-8543
Mailing Address - Country:US
Mailing Address - Phone:281-841-6851
Mailing Address - Fax:281-841-6851
Practice Address - Street 1:9329 CIELO DR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-8543
Practice Address - Country:US
Practice Address - Phone:281-841-6851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-02
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44742183500000X
TN0000022033183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist