Provider Demographics
NPI:1518489939
Name:HUNTER, WILLIAM J (RPH)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
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 1:23 N BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT ANTHONY
Mailing Address - State:ID
Mailing Address - Zip Code:83445-2110
Mailing Address - Country:US
Mailing Address - Phone:208-624-3202
Mailing Address - Fax:208-624-3760
Practice Address - Street 1:23 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:SAINT ANTHONY
Practice Address - State:ID
Practice Address - Zip Code:83445-2110
Practice Address - Country:US
Practice Address - Phone:208-624-3202
Practice Address - Fax:208-624-3202
Is Sole Proprietor?:No
Enumeration Date:2017-07-07
Last Update Date:2017-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID45401RP183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist