Healthcare Provider Details

I. General information

NPI: 1235569583
Provider Name (Legal Business Name): ANDREW HUTCHINS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2013
Last Update Date: 11/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 17 MILE RD NE
CEDAR SPRINGS MI
49319-7974
US

IV. Provider business mailing address

3700 17 MILE RD NE
CEDAR SPRINGS MI
49319-7974
US

V. Phone/Fax

Practice location:
  • Phone: 616-696-4610
  • Fax:
Mailing address:
  • Phone: 616-696-4610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302029007
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: