Healthcare Provider Details

I. General information

NPI: 1487402103
Provider Name (Legal Business Name): STEVEN A HULETT PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2024
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2548 GREENUP AVE
ASHLAND KY
41101-7852
US

IV. Provider business mailing address

207 MOUNTAIN DR
GREENUP KY
41144-6182
US

V. Phone/Fax

Practice location:
  • Phone: 606-408-7779
  • Fax:
Mailing address:
  • Phone: 606-585-8411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03439036
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number020640
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: