Organization
HIS CARE LLC
Active
Other names
THE DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY HETHCOX RPH (OWNER)
(912) 739-9393
Entity
Organization
Contact information
Practice address
305 E LONG ST, CLAXTON, GA 30417-1411
(912) 739-9393
(912) 739-9033
Mailing address
PO BOX 577, CLAXTON, GA 30417-0577
(912) 739-9393
(912) 739-9033
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE008624
GA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2014598
PK
—
05
—
944541867A
—
GA
05
—
944541867B
—
GA
Enumeration date
09/23/2006
Last updated
09/22/2016
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