MEDICARE: MS. MARY HULSEY R.PH

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	PD12908	AR
2	183500000X	Pharmacist	PH044312	MO

General Provider Information

NPI Number	:	1508259441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY HULSEY R.PH

Provider Business Mailing Address
First Line	:	1661 AIRPORT RD STE D
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-8184
Country	:	US
Telephone Number	:	501-625-7500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1661 AIRPORT RD STE D
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-8184
Country	:	US
Telephone Number	:	501-625-7500
Fax Number	:

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

Provider Enumeration Date	:	03/17/2015
Last Update Date	:	02/13/2017

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