Organization
HUTTULA ENTERPRISES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM HUTTULA (OWNER, PRESIDENT, PIC, AO)
(360) 495-0700
Entity
Organization
Contact information
Practice address
115 W SIMPSON AVE, MCCLEARY, WA 98557
(360) 495-0700
(360) 495-0011
Mailing address
PO BOX 88, MCCLEARY, WA 98557-0088
(360) 495-0700
(360) 495-0011
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR.CF.60625079
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2056816
—
WA
01
—
2158869
PK
—
Enumeration date
03/21/2016
Last updated
11/12/2020
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