Healthcare Provider Details
I. General information
NPI: 1215957808
Provider Name (Legal Business Name): HYGEIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/19/2006
Last Update Date: 04/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
421 FARM LIFE AVE
VANCEBORO NC
28586
US
IV. Provider business mailing address
PO BOX 218
VANCEBORO NC
28586-0218
US
V. Phone/Fax
- Phone: 252-244-1086
- Fax: 252-244-2264
- Phone: 252-244-1086
- Fax: 252-244-2264
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 3631 |
| License Number State | NC |
VIII. Authorized Official
Name:
ERNEST
G
HARGETT
Title or Position: PRESIDENT
Credential: RPH
Phone: 252-244-1086