Provider Demographics
NPI:1992086946
Name:HYTREE, DAVID CHARLES (RPH)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:CHARLES
Last Name:HYTREE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7634 KENNETH DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD TWP
Mailing Address - State:OH
Mailing Address - Zip Code:44077-8991
Mailing Address - Country:US
Mailing Address - Phone:440-392-2349
Mailing Address - Fax:
Practice Address - Street 1:5881 SOM CENTER RD
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-3036
Practice Address - Country:US
Practice Address - Phone:440-946-4357
Practice Address - Fax:440-946-5329
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-05
Last Update Date:2011-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03208438183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist