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General NPI Number Information
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NPI Number | 1265168819
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Entity Type | Individual
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Provider Name | ORY BRAD HUTCHISON PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/26/2022
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Last Update Date | 07/26/2022
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Provider Practice Location Address
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Address Line | 152 S 4TH ST
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City | MONTPELIER
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State | ID
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Zip | 83254-1538
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Country | US
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Telephone | 208-847-2108
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Fax | 208-847-2109
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Provider Business Mailing Address
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Address Line | 517 W 100 N STE 210
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City | PROVIDENCE
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State | UT
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Zip | 84332-9826
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Country | US
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Telephone | 435-755-6061
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Fax | 435-994-9862
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | P8488
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 7792431
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PR55676
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License Number State | ID
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