Healthcare Provider Details

I. General information

NPI: 1437679214
Provider Name (Legal Business Name): AARON HUTCHINSON JR. PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2017
Last Update Date: 06/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 BOLL WEEVIL CIR
ENTERPRISE AL
36330-2715
US

IV. Provider business mailing address

600 BOLL WEEVIL CIR
ENTERPRISE AL
36330-2715
US

V. Phone/Fax

Practice location:
  • Phone: 334-347-2199
  • Fax: 334-347-3095
Mailing address:
  • Phone: 334-347-2199
  • Fax: 334-347-3095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9386
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: