MEDICARE: HIXSON DRUGS LLC

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	3336C0003X	Community/Retail Pharmacy	2012022441	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2137835	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932203973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIXSON DRUGS LLC

Provider Business Mailing 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

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
Name	:	KEVIN HOWARD
Credential	:
Telephone Number	:	417-581-7777

Provider Enumeration Date	:	09/11/2006
Last Update Date	:	11/10/2016

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Directions to “HIXSON DRUGS LLC ” Practice Location

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