Healthcare Provider Details

I. General information

NPI: 1477737864
Provider Name (Legal Business Name): DOUGLAS J. HOSIE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2007
Last Update Date: 12/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5533 CLARK RD
CONESUS NY
14435-9549
US

IV. Provider business mailing address

5533 CLARK RD
CONESUS NY
14435-9549
US

V. Phone/Fax

Practice location:
  • Phone: 585-346-6375
  • Fax:
Mailing address:
  • Phone: 585-346-6375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number036580
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: