Provider Demographics
NPI:1437495611
Name:HUNT, RALPH KELLY (RPH)
Entity Type:Individual
Prefix:MR
First Name:RALPH
Middle Name:KELLY
Last Name:HUNT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 WREN CROSSING LN
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29642-7830
Mailing Address - Country:US
Mailing Address - Phone:864-270-1469
Mailing Address - Fax:
Practice Address - Street 1:704 BRUSHY CREEK ROAD
Practice Address - Street 2:KELLY'S FAMILY PHARMACY
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29642-7830
Practice Address - Country:US
Practice Address - Phone:864-270-1469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8836183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist