Healthcare Provider Details
I. General information
NPI: 1154497287
Provider Name (Legal Business Name): BRUCE LARKIN HOTCHKISS PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23610 E BROADWAY AVE
LIBERTY LAKE WA
99019-9641
US
IV. Provider business mailing address
23610 E BROADWAY AVE
LIBERTY LAKE WA
99019-9641
US
V. Phone/Fax
- Phone: 509-892-5796
- Fax:
- Phone: 509-892-5796
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1835P1200X |
| Taxonomy | Pharmacotherapy Pharmacist |
| License Number | 1 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: