Anthony Chad Hethcox, R.PH.
Individual provider Active NPI Pharmacist · Claxton, GA
NPI 1245337674 · NPPES record last updated Jun 19, 2017
Key facts
- NPI
- 1245337674
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH017487 (GA)
- Practice address
- 305 E Long St
Claxton, GA 30417-1411 - Phone
- (912) 739-9393
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH017487 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| His Care LLC | Current | Accepting new patients |
Locations
305 E Long St
Claxton, GA 30417
Phone (912) 739-9393
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH017487 | GA | Yes |
Addresses
Primary practice location
305 E Long St
Claxton, GA 30417-1411
Mailing address
PO Box 577
Claxton, GA 30417-0577
Phone (912) 739-9393
Other providers in Claxton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.