Provider Demographics
NPI:1477325553
Name:HOSKINSON ANCILLARY SERVICES LLC
Entity Type:Organization
Organization Name:HOSKINSON ANCILLARY SERVICES LLC
Other - Org Name:HOSKINSON PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER, CHIEF MEDICAL OFFI
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HOSKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:307-387-9850
Mailing Address - Street 1:469 HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82718-9330
Mailing Address - Country:US
Mailing Address - Phone:307-387-9850
Mailing Address - Fax:
Practice Address - Street 1:469 HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82718-9330
Practice Address - Country:US
Practice Address - Phone:307-387-9850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy