Provider Demographics
NPI:1508505033
Name:HUNTER, ADARRYL (RPH)
Entity Type:Individual
Prefix:
First Name:ADARRYL
Middle Name:
Last Name:HUNTER
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 1:1620 S CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:OWATONNA
Mailing Address - State:MN
Mailing Address - Zip Code:55060-3922
Mailing Address - Country:US
Mailing Address - Phone:507-451-0179
Mailing Address - Fax:
Practice Address - Street 1:1620 S CEDAR AVE
Practice Address - Street 2:
Practice Address - City:OWATONNA
Practice Address - State:MN
Practice Address - Zip Code:55060-3922
Practice Address - Country:US
Practice Address - Phone:507-451-0179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN125032183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist