Healthcare Provider Details

I. General information

NPI: 1013082908
Provider Name (Legal Business Name): HUNTERPHARM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 DOROTHY NICHOLS LN UNIT A
SMITHVILLE TX
78957
US

IV. Provider business mailing address

1501 DOROTHY NICHOLS LN UNIT A
SMITHVILLE TX
78957
US

V. Phone/Fax

Practice location:
  • Phone: 512-237-5216
  • Fax: 512-237-4015
Mailing address:
  • Phone: 512-360-3322
  • Fax: 512-237-4015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number15151
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. VICTOR C BARRAS
Title or Position: PHARMACIST
Credential: RPH
Phone: 512-237-5216