Provider Demographics
NPI:1841302858
Name:HILTON ENTERPRISES INC
Entity type:Organization
Organization Name:HILTON ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HILTON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:423-547-0696
Mailing Address - Street 1:625 W ELK AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTON
Mailing Address - State:TN
Mailing Address - Zip Code:37643-2559
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:625 W ELK AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETHTON
Practice Address - State:TN
Practice Address - Zip Code:37643-2559
Practice Address - Country:US
Practice Address - Phone:423-547-0696
Practice Address - Fax:423-547-9147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2956333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4428668OtherOTHER ID NUMBER-COMMERCIAL NUMBER
TN1454960Medicaid
TN1454960Medicaid
TN3914395Medicare PIN
4428668OtherOTHER ID NUMBER-COMMERCIAL NUMBER