MEDICARE: JOCQUELYN LE'QUON HILL 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	022736	GA

General Provider Information

NPI Number	:	1134403959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOCQUELYN LE'QUON HILL RPH

Provider Business Mailing Address
First Line	:	5675 JONESBORO RD
Second Line	:
City	:	LAKE CITY
State	:	GA
Zip	:	30260-3804
Country	:	US
Telephone Number	:	678-422-1808
Fax Number	:	678-422-2064

Provider Business Practice Location Address
First Line	:	5675 JONESBORO RD
Second Line	:
City	:	LAKE CITY
State	:	GA
Zip	:	30260-3804
Country	:	US
Telephone Number	:	678-422-1808
Fax Number	:	678-422-2064

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

Provider Enumeration Date	:	09/29/2011
Last Update Date	:	09/29/2011

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