Healthcare Provider Details

I. General information

NPI: 1942315973
Provider Name (Legal Business Name): HUNTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 02/22/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 S MAIN ST
DRIGGS ID
83422-9700
US

IV. Provider business mailing address

PO BOX 758
DRIGGS ID
83422-0758
US

V. Phone/Fax

Practice location:
  • Phone: 208-354-2334
  • Fax: 208-354-3646
Mailing address:
  • Phone:
  • Fax: 208-354-3646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number108RP
License Number StateID

VIII. Authorized Official

Name: AARON MYLER
Title or Position: MANAGER
Credential:
Phone: 208-354-2334