Organization
HYATT'S MARKET INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEXTER W HEARN PHARM.D. (PHARMACY MANAGER)
(256) 747-6066
Entity
Organization
Contact information
Practice address
70 MCHANN RD, ADDISON, AL 35540-2138
(256) 747-6066
(256) 747-6046
Mailing address
70 MCHANN RD, ADDISON, AL 35540-2138
(256) 747-6066
(256) 747-6046
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
111746
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009961470
MEDICAID DME NUMBER
AL
01
—
0130031
NABP NUMBER
AL
05
—
100003169
—
AL
Enumeration date
08/14/2006
Last updated
03/07/2023
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