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General NPI Number Information
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NPI Number | 1285908582
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Entity Type | Organization
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Legal Business Name | HACKLEBUG PHARMACY INC.
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Dates
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Enumeration Date | 03/05/2012
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Last Update Date | 03/05/2012
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Provider Practice Location Address
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Address Line | 34863 US HIGHWAY 43
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City | HACKLEBURG
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State | AL
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Zip | 35564
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Country | US
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Telephone | 205-516-4659
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Fax | 205-935-3779
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Provider Business Mailing Address
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Address Line | 34863 US HIGHWAY 43
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City | HACKLEBURG
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State | AL
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Zip | 35564
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Country | US
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Telephone | 205-516-4659
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Fax | 205-935-3779
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. VINCENT W HUGHES
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Credential |
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Telephone | 205-516-4659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 11066
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License Number State | AL
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