Provider Demographics
NPI:1992276794
Name:HUTTULA ENTERPRISES INC
Entity type:Organization
Organization Name:HUTTULA ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE (PIC)
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:HUTTULA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:360-861-8670
Mailing Address - Street 1:PO BOX 558
Mailing Address - Street 2:
Mailing Address - City:ELMA
Mailing Address - State:WA
Mailing Address - Zip Code:98541-0558
Mailing Address - Country:US
Mailing Address - Phone:360-861-8670
Mailing Address - Fax:360-861-8620
Practice Address - Street 1:610 E MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ELMA
Practice Address - State:WA
Practice Address - Zip Code:98541
Practice Address - Country:US
Practice Address - Phone:360-861-8670
Practice Address - Fax:360-861-8620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-06
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy