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General NPI Number Information
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NPI Number | 1023004215
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Entity Type | Organization
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Legal Business Name | HUTTON PHARMACY INC
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Dates
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Enumeration Date | 09/22/2005
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Last Update Date | 12/12/2014
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Provider Practice Location Address
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Address Line | 119 N MAIN ST
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City | BLACKWELL
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State | OK
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Zip | 74631-2226
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Country | US
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Telephone | 580-363-2137
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Fax | 580-363-5582
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Provider Business Mailing Address
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Address Line | PO BOX 110
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City | BLACKWELL
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State | OK
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Zip | 74631-0110
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Country | US
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Telephone | 580-363-2137
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Fax | 580-363-5582
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Authorized Official
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Title or Position | OWNER
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Name | DENNIS HUTTON
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Credential |
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Telephone | 580-363-2137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 61743
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License Number State | OK
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