Hewitt Drug

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28666 Issued in TX

Legal business name

HEWITT DRUG

Practice address

511 N Hewitt Dr
Suite 1
Hewitt, TX 76643-3000

Phone

(254) 666-5000

Fax

(254) 666-5002

NPI assigned

Jul 25, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Matthew Darby Wagoner, RPHNPI 1033705363

Title

Pharmacist in Charge

Phone

(254) 733-3032

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Lynn's Pharmacy Hewitt Doing business as

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

Tax ID family

Hewitt Drug2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Hewitt Drug

  • Long Term Care Pharmacy
  • Hewitt, TX
  • NPI 1962022442
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Darby Wagoner, RPH

  • Pharmacist
  • Hewitt, TX
  • NPI 1033705363
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587686400000",
    "number": "1205278686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 N HEWITT DR",
            "address_2": "SUITE 1",
            "city": "HEWITT",
            "state": "TX",
            "postal_code": "766433000",
            "telephone_number": "254-666-5000",
            "fax_number": "254-666-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 N HEWITT DR",
            "address_2": "SUITE 1",
            "city": "HEWITT",
            "state": "TX",
            "postal_code": "766433000",
            "telephone_number": "254-666-5000",
            "fax_number": "254-666-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEWITT DRUG",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-25",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A",
        "authorized_official_last_name": "WAGONER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "DARBY",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "254-733-3032",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "TX",
            "license": "28666",
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TX",
            "license": "28666",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "28666",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "28666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148899",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS PHARMACY PERMIT",
            "identifier": "28666",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lynn's Pharmacy Hewitt",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Hardt, LCSW
• Jeremiah Daniel Havins, MD
• Carla Hayes, LVN
• Helping Hands Therapy Center
• Ashley Henderson, RBT
• Hewitt Drug
• Hewitt SCC LLC
• Hewitt Vision, PLLC
• Ashley Hickman, COTA
• Rebecca Holloway, RBT

• Community/Retail Pharmacy in Hewitt, TX
• Providers in Hewitt, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.