Provider Demographics
NPI:1760494470
Name:HESTER DRUGS INC
Entity type:Organization
Organization Name:HESTER DRUGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:731-665-6176
Mailing Address - Street 1:114 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:TN
Mailing Address - Zip Code:38369
Mailing Address - Country:US
Mailing Address - Phone:731-665-6176
Mailing Address - Fax:731-665-6786
Practice Address - Street 1:114 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RUTHERFORD
Practice Address - State:TN
Practice Address - Zip Code:38369
Practice Address - Country:US
Practice Address - Phone:731-665-6176
Practice Address - Fax:731-665-6786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 183500000X
TN10993336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5850390001Medicare NSC