MEDICARE: DR. BRIAN THOMAS HOCUM 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	PH60213040	WA

General Provider Information

NPI Number	:	1437445624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN THOMAS HOCUM PHARMD

Provider Business Mailing Address
First Line	:	1844 5TH AVE
Second Line	:
City	:	CLARKSTON
State	:	WA
Zip	:	99403-1402
Country	:	US
Telephone Number	:	509-552-6764
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 6TH ST
Second Line	:
City	:	CLARKSTON
State	:	WA
Zip	:	99403-2013
Country	:	US
Telephone Number	:	509-758-2565
Fax Number	:

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

Provider Enumeration Date	:	06/26/2011
Last Update Date	:	06/26/2011

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