Healthcare Provider Details

I. General information

NPI: 1265702146
Provider Name (Legal Business Name): CARMEN HUTTER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2012
Last Update Date: 01/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14502 W MEEKER BLVD
SUN CITY WEST AZ
85375-5282
US

IV. Provider business mailing address

14502 W MEEKER BLVD
SUN CITY WEST AZ
85375-5282
US

V. Phone/Fax

Practice location:
  • Phone: 623-524-4070
  • Fax: 623-524-4103
Mailing address:
  • Phone: 623-524-4070
  • Fax: 623-524-4103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15419
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: