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NPI Code Detail

MEDICARE: KATHY JEAN HUSSONG PHARMD

MEDICARE: KATHY JEAN HUSSONG 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
1183500000XPharmacist011090SC

General Provider Information

NPI Number : 1871657676
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHY JEAN HUSSONG PHARMD
Provider Business Mailing Address
First Line : 15 JINGLE SHELL LN
Second Line :
City : HILTON HEAD ISLAND
State : SC
Zip : 29926-1958
Country : US
Telephone Number : 843-689-9004
Fax Number :
Provider Business Practice Location Address
First Line : 1101 MAIN ST
Second Line :
City : HILTON HEAD ISLAND
State : SC
Zip : 29926-1624
Country : US
Telephone Number : 843-681-2622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2006
Last Update Date : 07/08/2007

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Directions to “ KATHY JEAN HUSSONG PHARMD” Practice Location

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