Provider Demographics
NPI:1841281896
Name:HUGHES, JAROLD KEITH (PHARMACIST)
Entity type:Individual
Prefix:
First Name:JAROLD
Middle Name:KEITH
Last Name:HUGHES
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 2ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:CRESCO
Mailing Address - State:IA
Mailing Address - Zip Code:52136-1206
Mailing Address - Country:US
Mailing Address - Phone:563-547-5111
Mailing Address - Fax:563-547-5113
Practice Address - Street 1:2977 OAK AVE
Practice Address - Street 2:
Practice Address - City:LIME SPRINGS
Practice Address - State:IA
Practice Address - Zip Code:52155-8132
Practice Address - Country:US
Practice Address - Phone:563-203-2171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA15034183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist