Provider Demographics
NPI:1982987210
Name:HUTCHINGS, KRIS (RPH)
Entity type:Individual
Prefix:
First Name:KRIS
Middle Name:
Last Name:HUTCHINGS
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 1:3497 TECHNOLOGY DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-2599
Mailing Address - Country:US
Mailing Address - Phone:636-625-0691
Mailing Address - Fax:636-625-0694
Practice Address - Street 1:3497 TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:LAKE ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63367-2599
Practice Address - Country:US
Practice Address - Phone:636-625-0691
Practice Address - Fax:636-625-0694
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO044195183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2637164Medicaid