Provider Demographics
NPI:1053858837
Name:HUNT, LAWRENCE TAYLOR (PHARMD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:TAYLOR
Last Name:HUNT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1337 W HEREFORD DR
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85143-5045
Mailing Address - Country:US
Mailing Address - Phone:480-316-0876
Mailing Address - Fax:
Practice Address - Street 1:1337 W HEREFORD DR
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85143-5045
Practice Address - Country:US
Practice Address - Phone:480-316-0876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS022316183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist