Healthcare Provider Details

I. General information

NPI: 1821471335
Provider Name (Legal Business Name): JON HILTON RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2015
Last Update Date: 07/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 DAKOTA AVE S
HURON SD
57350-4311
US

IV. Provider business mailing address

2150 DAKOTA AVE S
HURON SD
57350-4311
US

V. Phone/Fax

Practice location:
  • Phone: 605-352-1641
  • Fax: 605-352-9663
Mailing address:
  • Phone: 605-352-1641
  • Fax: 605-352-9663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberR4683
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: