MEDICARE: HIXSON DRUG INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0002X	Clinic Pharmacy	5042	MO

General Provider Information

NPI Number	:	1629176037
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIXSON DRUG INC

Provider Business Mailing Address
First Line	:	604A E SOUTH ST
Second Line	:	PO BOX 459
City	:	OZARK
State	:	MO
Zip	:	65721-8912
Country	:	US
Telephone Number	:	417-581-7777
Fax Number	:	417-581-8152

Provider Business Practice Location Address
First Line	:	604A E SOUTH ST
Second Line	:
City	:	OZARK
State	:	MO
Zip	:	65721-8912
Country	:	US
Telephone Number	:	417-581-7777
Fax Number	:	417-581-8152

Authorized Official
Title or Position	:	OWNER/PHARMACIST
Name	:	MR. CARL HEFNER
Credential	:	RPH
Telephone Number	:	417-581-7777

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/22/2020

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Directions to “HIXSON DRUG INC ” Practice Location

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