Provider Demographics
NPI:1841573235
Name:HUNT, THOMAS DEAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:DEAN
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 1:27951 BASELINE ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-3346
Mailing Address - Country:US
Mailing Address - Phone:909-864-5701
Mailing Address - Fax:909-864-5981
Practice Address - Street 1:800 E LUGONIA AVE
Practice Address - Street 2:SUITE M
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-2550
Practice Address - Country:US
Practice Address - Phone:909-307-6964
Practice Address - Fax:909-798-3967
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36694183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist