Provider Demographics
NPI:1376050385
Name:HUNTERS INC
Entity Type:Organization
Organization Name:HUNTERS INC
Other - Org Name:VICTOR DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:MYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-354-2334
Mailing Address - Street 1:PO BOX 758
Mailing Address - Street 2:
Mailing Address - City:DRIGGS
Mailing Address - State:ID
Mailing Address - Zip Code:83422-0758
Mailing Address - Country:US
Mailing Address - Phone:208-787-3784
Mailing Address - Fax:208-787-3763
Practice Address - Street 1:81 N. MAIN ST.
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:ID
Practice Address - Zip Code:83455
Practice Address - Country:US
Practice Address - Phone:208-787-3784
Practice Address - Fax:208-787-3763
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUNTERS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-29
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1376050385Medicaid