Healthcare Provider Details

I. General information

NPI: 1679173611
Provider Name (Legal Business Name): KEITH MCBRAYER HUNT RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: KEITH MCBRAYER HUNT RPH

II. Dates (important events)

Enumeration Date: 10/29/2020
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 BOSTIC SUNSHINE HWY
BOSTIC NC
28018-9779
US

IV. Provider business mailing address

630 BOSTIC SUNSHINE HWY
BOSTIC NC
28018-9779
US

V. Phone/Fax

Practice location:
  • Phone: 479-721-3421
  • Fax:
Mailing address:
  • Phone: 479-721-3421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11778
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: