MEDICARE: DAVID W VOGHT

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	34315	NY

General Provider Information

NPI Number	:	1972826162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID W VOGHT

Provider Business Mailing Address
First Line	:	26 CHURCH ST
Second Line	:
City	:	CANAJOHARIE
State	:	NY
Zip	:	13317-1165
Country	:	US
Telephone Number	:	518-673-8086
Fax Number	:	518-673-5112

Provider Business Practice Location Address
First Line	:	26 CHURCH ST
Second Line	:
City	:	CANAJOHARIE
State	:	NY
Zip	:	13317-1165
Country	:	US
Telephone Number	:	518-673-8086
Fax Number	:	518-673-5112

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

Provider Enumeration Date	:	03/02/2010
Last Update Date	:	03/02/2010

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