MEDICARE: MR. KEVIN WILLIAM HUGHES 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	RP033582L	PA

General Provider Information

NPI Number	:	1871592758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KEVIN WILLIAM HUGHES R.PH.

Provider Business Mailing Address
First Line	:	1565 NEW VALLEY RD
Second Line	:
City	:	MARYSVILLE
State	:	PA
Zip	:	17053-9417
Country	:	US
Telephone Number	:	860-209-0644
Fax Number	:

Provider Business Practice Location Address
First Line	:	1565 NEW VALLEY RD
Second Line	:
City	:	MARYSVILLE
State	:	PA
Zip	:	17053-9417
Country	:	US
Telephone Number	:	860-209-0644
Fax Number	:

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	02/03/2017

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