Provider Demographics
NPI:1427169598
Name:H AND W DRUG COMPANY, LLC
Entity type:Organization
Organization Name:H AND W DRUG COMPANY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:MAUGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-758-3611
Mailing Address - Street 1:2312 6TH ST # B
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-1741
Mailing Address - Country:US
Mailing Address - Phone:205-758-3611
Mailing Address - Fax:205-758-9441
Practice Address - Street 1:2312 6TH ST # B
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-1741
Practice Address - Country:US
Practice Address - Phone:205-758-3611
Practice Address - Fax:205-758-9441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL104868183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100000479Medicaid
ALAH0478986OtherDEA
AL100000479Medicaid