Provider Demographics
NPI:1386743367
Name:HOGUE, KAREN LYNN (RPH)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LYNN
Last Name:HOGUE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 PRINCETON AVE
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830-1714
Mailing Address - Country:US
Mailing Address - Phone:607-329-2769
Mailing Address - Fax:607-936-7026
Practice Address - Street 1:26 W MARKET ST
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-2617
Practice Address - Country:US
Practice Address - Phone:607-936-7023
Practice Address - Fax:607-936-7026
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034210183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01797231Medicaid