Provider Demographics
NPI:1932475803
Name:HUGHES, DAVID JOHN (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JOHN
Last Name:HUGHES
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 1:21162 NEWBERRY CT
Mailing Address - Street 2:
Mailing Address - City:SCANDIA
Mailing Address - State:MN
Mailing Address - Zip Code:55073-9104
Mailing Address - Country:US
Mailing Address - Phone:651-295-9955
Mailing Address - Fax:
Practice Address - Street 1:200 UNIVERSITY AVE E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2507
Practice Address - Country:US
Practice Address - Phone:651-726-2890
Practice Address - Fax:651-726-2848
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN114840183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist