MEDICARE: STEVEN CHARLES HUTCHESON PHARMACIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	028670	MO

General Provider Information

NPI Number	:	1699763383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN CHARLES HUTCHESON PHARMACIST

Provider Business Mailing Address
First Line	:	1330 SOUTH HIGHWAY 63
Second Line	:	PO BOX 577
City	:	HOUSTON
State	:	MO
Zip	:	65483
Country	:	US
Telephone Number	:	417-967-4139
Fax Number	:	417-967-4130

Provider Business Practice Location Address
First Line	:	1330 SOUTH HIGHWAY 63
Second Line	:
City	:	HOUSTON
State	:	MO
Zip	:	65483
Country	:	US
Telephone Number	:	417-967-4139
Fax Number	:	417-967-4130

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	07/08/2007

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