MEDICARE: NATALIE HOSELTON RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	2000174391	MO

General Provider Information

NPI Number	:	1073894093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE HOSELTON RPH

Provider Business Mailing Address
First Line	:	103 WYNDGATE VALLEY DR
Second Line	:
City	:	LAKE ST LOUIS
State	:	MO
Zip	:	63367-4307
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	499 SALT LICK RD
Second Line	:
City	:	SAINT PETERS
State	:	MO
Zip	:	63376-1290
Country	:	US
Telephone Number	:	636-278-3802
Fax Number	:	636-278-3808

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2011
Last Update Date	:	09/03/2011

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