Healthcare Provider Details

I. General information

NPI: 1689723348
Provider Name (Legal Business Name): LADONA MARIE HUNTER PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 ALSTON ST.
RICHLAND GA
31825
US

IV. Provider business mailing address

PO BOX 206 457 WASHINGTON STREET
PRESTON GA
31824-0206
US

V. Phone/Fax

Practice location:
  • Phone: 229-887-3747
  • Fax:
Mailing address:
  • Phone: 229-828-7912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17763
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: