MEDICARE: MR. RICHARD COLE HOOSER 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	17527	NC

General Provider Information

NPI Number	:	1710237045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICHARD COLE HOOSER RPH

Provider Business Mailing Address
First Line	:	185 CHICAHAUK TRAIL
Second Line	:
City	:	SOUTHERN SHORES
State	:	NC
Zip	:	27949
Country	:	US
Telephone Number	:	252-715-3237
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 US HIGHWAY 64 E
Second Line	:
City	:	PLYMOUTH
State	:	NC
Zip	:	27962-2200
Country	:	US
Telephone Number	:	252-793-1175
Fax Number	:

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

Provider Enumeration Date	:	09/13/2012
Last Update Date	:	07/17/2013

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