Provider Demographics
NPI:1013082908
Name:HUNTERPHARM INC
Entity Type:Organization
Organization Name:HUNTERPHARM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:C
Authorized Official - Last Name:BARRAS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:512-237-5216
Mailing Address - Street 1:1501 DOROTHY NICHOLS LN
Mailing Address - Street 2:UNIT A
Mailing Address - City:SMITHVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78957
Mailing Address - Country:US
Mailing Address - Phone:512-360-3322
Mailing Address - Fax:512-237-4015
Practice Address - Street 1:1501 DOROTHY NICHOLS LN
Practice Address - Street 2:UNIT A
Practice Address - City:SMITHVILLE
Practice Address - State:TX
Practice Address - Zip Code:78957
Practice Address - Country:US
Practice Address - Phone:512-237-5216
Practice Address - Fax:512-237-4015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15151333600000X
3336C0003X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148792Medicaid
TX143870Medicaid