Healthcare Provider Details

I. General information

NPI: 1588659940
Provider Name (Legal Business Name): JOHN LOUIS HUTTMEYER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

443 HIGHWAY 35
RED BANK NJ
07701-5036
US

IV. Provider business mailing address

41 COLD INDIAN SPRINGS RD
OCEAN NJ
07712-3358
US

V. Phone/Fax

Practice location:
  • Phone: 732-747-1500
  • Fax:
Mailing address:
  • Phone: 732-539-8325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02175000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: