MEDICARE: JAROLD KEITH HUGHES PHARMACIST

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	15034	IA

General Provider Information

NPI Number	:	1841281896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAROLD KEITH HUGHES PHARMACIST

Provider Business Mailing Address
First Line	:	303 2ND AVE SW
Second Line	:
City	:	CRESCO
State	:	IA
Zip	:	52136-1206
Country	:	US
Telephone Number	:	563-547-5111
Fax Number	:	563-547-5113

Provider Business Practice Location Address
First Line	:	2977 OAK AVE
Second Line	:
City	:	LIME SPRINGS
State	:	IA
Zip	:	52155-8132
Country	:	US
Telephone Number	:	563-203-2171
Fax Number	:

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

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	09/02/2016

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