Individual provider Active NPI

Bret Donald Huxtable, PHARMD

  • Pharmacist
  • Lake Havasu City, AZ
National Provider Identifier
1245913128
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S026597 Issued in AZ
Practice address
1650 McCulloch Blvd N
Lake Havasu City, AZ 86403-0961
Phone
(928) 855-9200
NPI assigned
Aug 8, 2023
Last updated
Aug 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S026597 AZ Primary

Addresses

Primary practice location

1650 McCulloch Blvd N
Lake Havasu City, AZ 86403-0961

Mailing address

3820 Breakwater Dr
Lake Havasu City, AZ 86406-4357
Phone (406) 274-6911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
S026597AZMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1245913128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 BREAKWATER DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864064357",
            "telephone_number": "406-274-6911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 MCCULLOCH BLVD N",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864030961",
            "telephone_number": "928-855-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUXTABLE",
        "first_name": "BRET",
        "middle_name": "DONALD",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S026597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.