Healthcare Provider Details

I. General information

NPI: 1306004528
Provider Name (Legal Business Name): DUANE E HUGHES RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2008
Last Update Date: 12/19/2022
Certification Date: 09/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2102 NEZ PERCE DR
LEWISTON ID
83501-4116
US

IV. Provider business mailing address

2102 NEZ PERCE DR
LEWISTON ID
83501-4116
US

V. Phone/Fax

Practice location:
  • Phone: 208-743-4434
  • Fax:
Mailing address:
  • Phone: 208-743-4434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH0009584
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberP7024
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: