Healthcare Provider Details

I. General information

NPI: 1588687214
Provider Name (Legal Business Name): BEN HUNN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 S WINCHESTER AVE
MILES CITY MT
59301-4742
US

IV. Provider business mailing address

121 MEADOW LN
MILES CITY MT
59301-5856
US

V. Phone/Fax

Practice location:
  • Phone: 406-874-5859
  • Fax: 406-874-5866
Mailing address:
  • Phone: 406-874-7474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3299
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: