Healthcare Provider Details

I. General information

NPI: 1780264127
Provider Name (Legal Business Name): HENRY EMMETTE HUTCHESON PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2021
Last Update Date: 04/09/2021
Certification Date: 04/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 E PARKCENTER BLVD
BOISE ID
83706-6721
US

IV. Provider business mailing address

909 E PARKCENTER BLVD
BOISE ID
83706-6721
US

V. Phone/Fax

Practice location:
  • Phone: 208-338-3722
  • Fax:
Mailing address:
  • Phone: 208-338-3722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberP9052
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: