Provider Demographics
NPI:1053832873
Name:HUTCHINSON, MARK ALAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:ALAN
Last Name:HUTCHINSON
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 1:7110 CUTTY SARK DR
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-4939
Mailing Address - Country:US
Mailing Address - Phone:727-239-2469
Mailing Address - Fax:
Practice Address - Street 1:1555 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-2374
Practice Address - Country:US
Practice Address - Phone:727-442-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-30
Last Update Date:2017-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS56351183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist