Provider Demographics
NPI:1720428089
Name:LUCHT, AUSTIN RYDER (PHARMD,RPH)
Entity type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:RYDER
Last Name:LUCHT
Suffix:
Gender:M
Credentials:PHARMD,RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1573 SIERRY PEAKS DR
Mailing Address - Street 2:UNIT A
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-2153
Mailing Address - Country:US
Mailing Address - Phone:402-760-1307
Mailing Address - Fax:
Practice Address - Street 1:1310 WILLOW CREEK RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-1492
Practice Address - Country:US
Practice Address - Phone:928-227-9965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ019833183500000X
NE14221183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist