Healthcare Provider Details

I. General information

NPI: 1639426182
Provider Name (Legal Business Name): ERIC JAMES HUTTON PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2012
Last Update Date: 08/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7751 49TH ST N
PINELLAS PARK FL
33781-3441
US

IV. Provider business mailing address

6321 113TH ST APT 1301
SEMINOLE FL
33772-6757
US

V. Phone/Fax

Practice location:
  • Phone: 727-544-5551
  • Fax:
Mailing address:
  • Phone: 614-623-2883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS49284
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: