Healthcare Provider Details

I. General information

NPI: 1851524656
Provider Name (Legal Business Name): ALFRED ERIC HEGWOOD PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2009
Last Update Date: 03/28/2021
Certification Date: 03/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1816 GUNBARREL RD
CHATTANOOGA TN
37421-3129
US

IV. Provider business mailing address

1816 GUNBARREL RD
CHATTANOOGA TN
37421-3129
US

V. Phone/Fax

Practice location:
  • Phone: 423-954-9063
  • Fax:
Mailing address:
  • Phone: 423-954-9063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number33829
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20161
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: