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General NPI Number Information
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NPI Number | 1720696974
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Entity Type | Individual
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Provider Name | HUNTER GAVIN HIGHLANDER PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/14/2020
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Last Update Date | 07/14/2020
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Provider Practice Location Address
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Address Line | 106 21ST ST
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City | NITRO
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State | WV
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Zip | 25143-1740
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Country | US
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Telephone | 304-755-9015
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Fax |
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Provider Business Mailing Address
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Address Line | 405 OLDE ORCHARD DR
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City | HURRICANE
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State | WV
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Zip | 25526-7439
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Country | US
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Telephone | 304-940-0490
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP0011736
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License Number State | WV
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