Provider Demographics
NPI:1386358588
Name:HU, RICHARD JAY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JAY
Last Name:HU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 DAUTEL LN
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-5488
Mailing Address - Country:US
Mailing Address - Phone:314-625-0678
Mailing Address - Fax:
Practice Address - Street 1:1415 DAUTEL LN
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-5488
Practice Address - Country:US
Practice Address - Phone:314-625-0678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0041242183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist