Healthcare Provider Details

I. General information

NPI: 1417812603
Provider Name (Legal Business Name): HUNTER GRACE KLINE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

500 UNIVERSITY DR
HERSHEY PA
17033-2391
US

IV. Provider business mailing address

27 PEACE RD
DALLAS PA
18612-2655
US

V. Phone/Fax

Practice location:
  • Phone: 800-243-1455
  • Fax:
Mailing address:
  • Phone: 570-589-9633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP459434
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: