Nicholas Robert Hoag, PHARM D., RPH
Individual provider Active NPI Pharmacist · Carthage, MO
NPI 1508470980 · NPPES record last updated Sep 3, 2020
Key facts
- NPI
- 1508470980
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2019033481 (MO)
- Practice address
- 2737 S Grand Ave
Carthage, MO 64836-7907 - Phone
- (417) 358-4321
- NPI assigned
- Sep 3, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019033481 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2019033481 | MO | Yes |
Addresses
Primary practice location
2737 S Grand Ave
Carthage, MO 64836-7907
Mailing address
1715 Rex Ave Apt 157
Joplin, MO 64801-5925
Phone (314) 630-0816
Other providers in Carthage, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.