MEDICARE: MOLLY HOOD PHARMD

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	051300779	IL
2	183500000X	Pharmacist	2017031675	MO

General Provider Information

NPI Number	:	1336751205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOLLY HOOD PHARMD

Provider Business Mailing Address
First Line	:	7422 HIGHWAY N
Second Line	:
City	:	O FALLON
State	:	MO
Zip	:	63368-7013
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1833 KINGSHIGHWAY
Second Line	:
City	:	EAST SAINT LOUIS
State	:	IL
Zip	:	62204-2135
Country	:	US
Telephone Number	:	618-874-3000
Fax Number	:

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

Provider Enumeration Date	:	08/20/2020
Last Update Date	:	08/26/2021

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Directions to “ MOLLY HOOD PHARMD” Practice Location

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