Provider Demographics
NPI:1154759926
Name:HIW PHARMACY LLC
Entity type:Organization
Organization Name:HIW PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:E
Authorized Official - Last Name:MALVEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-298-9830
Mailing Address - Street 1:13111 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-1138
Mailing Address - Country:US
Mailing Address - Phone:469-250-1600
Mailing Address - Fax:
Practice Address - Street 1:13111 N CENTRAL EXPY
Practice Address - Street 2:SUITE 1000
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-1138
Practice Address - Country:US
Practice Address - Phone:469-250-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-14
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy