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NPI Code Detail

MEDICARE: DR. JACOB MICHAEL HUTTI PHARM.D.

MEDICARE: DR. JACOB MICHAEL HUTTI PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist7735KY

General Provider Information

NPI Number : 1033104542
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACOB MICHAEL HUTTI PHARM.D.
Provider Business Mailing Address
First Line : 1 EDEN PKWY
Second Line :
City : LA GRANGE
State : KY
Zip : 40031-8100
Country : US
Telephone Number : 502-587-1279
Fax Number :
Provider Business Practice Location Address
First Line : 2701 CHESTNUT STATION CT
Second Line :
City : LOUISVILLE
State : KY
Zip : 40299-6395
Country : US
Telephone Number : 502-526-0051
Fax Number : 502-526-0152
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2005
Last Update Date : 08/08/2019

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