Individual
PATRICK S HOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
12000 STONE LAKE ROAD, JICARILLA SERVICE UNIT, DULCE, NM 87528
(575) 759-7250
(575) 759-7288
Mailing address
HC 75 BX 66, CHAMA, NM 87520
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
30013
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000K3526
—
NM
01
—
HSZ196
MEDICARE PART B
NM
Enumeration date
05/05/2006
Last updated
05/29/2008
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