Provider Demographics
NPI:1356990436
Name:HUTCHESON, PENNY POUNCEY (RPH)
Entity type:Individual
Prefix:
First Name:PENNY
Middle Name:POUNCEY
Last Name:HUTCHESON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:PENNY
Other - Middle Name:POUNCEY
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:100 RUE TOULOUSE
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-2096
Mailing Address - Country:US
Mailing Address - Phone:318-393-7265
Mailing Address - Fax:
Practice Address - Street 1:1201 N SERVICE RD E
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-2917
Practice Address - Country:US
Practice Address - Phone:318-251-0392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD12463183500000X
LAPST.013351183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist