=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215957808
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HYGEIA, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/19/2006
-----------------------------------------------------
Last Update Date | 04/11/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 421 FARM LIFE AVE
-----------------------------------------------------
City | VANCEBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28586
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-244-1086
-----------------------------------------------------
Fax | 252-244-2264
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 218
-----------------------------------------------------
City | VANCEBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28586-0218
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-244-1086
-----------------------------------------------------
Fax | 252-244-2264
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | ERNEST G HARGETT
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 252-244-1086
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 3631
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------